
Class c^ 

Book 

Copyright ]^°_ 






COPYRIGHT DEPOSIT. 



VETERINARY MEDICINE SERIES 
No. 5 

Edited by D. M. CAMPBELL, D. V. S. 



CANINE MEDICINE 
AND SURGERY 



BY 

CHAS. G. SAUNDERS, V. S., B. V. Sc. 

Senior Professor Ontario Veterinary College, Professor 
Canine and Feline Medicine Ontario Veterinary 
College, Editor Canine Department Amer- 
ican Journal of Veterinary Medi- 
cine, O. C. No. 2 Sect. Canadian 
Army Veterinary 
Corps, Etc. 



Chicago 

AMERICAN JOURNAL OF VETERINARY MEDICINE 

1915 



.S3 



Copyright, 1915, 

BT 

D. M. Campbell 



MAR -3 1915 
©CIA:in3882 



PREFACE 

T N offering this little ^¥ork to the profession the 
■^ author wishes to point out that it is published 
mainly for the use of senior students and practi- 
tioners. It presumes a knowledge of pathology, 
histology and anatomy, and aims to deal only with 
the clinical aspect of the various diseases. It does 
not presume to be an encyclopedia, but deals merely 
with the conditions commonly found in everyday 
practice. If it succeeds in arousing more interest 
in and deeper study of canine practice, the author 
feels that his labor will not have been in vain. 
Toronto, Out. C. G. S. 



SENATOR VEST'S EULOGY ON THE DOG 



The best friend a man has in this world may turn against 
him and become his enemy. His son and daughter that he has 
reared with loving care may become ungrateful. Those who are 
nearest and dearest to us, those whom we trust with our happiness 
and our good name, may become traitors to their faith. The 
money that a man has he may lose. It flies away from him when 
he may need it most. Man's reputation may be sacrificed in a 
moment of ill-considered action. The people who are prone to 
fall on their knees and do us honor when success is with us may 
be the first to throw the stone of malice when failure settles its 
cloud upon our heads. The one absolutely unselfish fnend a man 
may have in this selfish world, the one that never deserts him, 
the one that never proves ungrateful or treacherous, is the dog. 

A man's dog stands by him in prosperity and poverty, in health 
and in sickness. He will sleep on the cold ground, when the 
win'.ry winds blow and the snow drives fiercely, if only he may 
be near his master's side. He will kiss the hand that has no food 
to offer, he will lick the wounds and sores that come In encounter 
with the roughness of the world. He guards the sleep of his 
pauper master as if he were a prince. 

When all o'Jier friends desert, he remains. When riches take 
wings and reputation falls to pieces he is as constant m his love 
as the sun in its journey through the heavens. If fortune drives 
the master forth an outcast into the world, friendless and homeless, 
the faithful dog asks no higher privilege than that of accompanying 
him, to guard him against danger, to fight against his enemies, 
and when the last scene of all comes and death takes his master 
in its embrace and his body is laid away in the cold ground, no 
matter if all other friends pursue their way, there by his graveside 
will the noble dog be found, his head between his paws and his 
eyes sad, but open in alert watchfulness, faithful and true even 
to death. 



CONTENTS 



PART I 

SECTION I. 



General Remarks 



SECTION II. 

Diseases of the Upper Respiratory Passages 12 

Simple Nasal Catarrh — Rhinitis — Coryza — Epis- 
taxis — Laryngitis — Chronic Laryngitis. 

SECTION III. 

Diseases of the Bronchi and Lungs 17 

Bronchitis — Acute Bronchitis — Chronic Bronchitis 
— Pneumonia — Lobar (Croupous) Pneumonia^ — Lobu- 
lar (Catarrhal) Pneumonia. 

SECTION IV. 

Diseases of the Pleur.e 31 

Pleurisy — Inflammation of the Pleura: Pleuritis — 
Hydrothorax (Dropsy of the Thoracic Cavity) — 
Pleurodynia. 

SECTION V. 

Diseases of the Mouth, Pharynx and Esophagus 37 

Stomatitis — Stomatitis Ulcerosa or Necrotic Stoma- 
titis — Glossitis — Ranula — Epulis — Papilloma or Wart 
— Neoplasms — Harelip and Cleft Palate — The Teeth — 
Tartar — Caries of the Teeth (Caries Dentum)— Em- 
pyema of the Superior Maxillary Sinus — Pharyngitis, 
or Sore Throat — Parotitis; Inflammation of the 
Parotid Gland (Mumps). 

SECTION VI. 

Diseases of the Stomach and Intestines 50 

Impaction of the Stomach — Gastritis — Acute Gas- 
tritis — Chronic Gastritis — Foreign Bodies in the 
Stomach — Intestinal Catarrh — Colic — Intussusception 
— Diarrhea — Constipation — Typhilitis — Enteritis. 

SECTION VII. 

Diseases of the Rectum and Anus 66 

Hemorrhoids — Prolapsus Recti — Amputation of the 
Prolapsed Rectum — Prolapsus Ani — Fistula in Ano — 
Atresia Ani — Obstruction of the Anal Glands. 



4 CONTENTS 

SECTION VIII. 

Diseases of the Liver 74 

Icterus or Jaundice — Catarrhal Jaundice — Hepto- 
genous Icterus — Hematogenous Icterus — Malignant 
Malarial Jaundice — Hepatitis; Inflammation of the 
Liver — Cirrhosis of the Liver; Interstitial Hepatitis 
— Ascites or Abdominal Dropsy — Diabetes Mellitus. 

SECTION IX. 

Diseases of the Kidney 82 

Acute Inflammation of the Kidney; Acute Ne- 
phritis — Chronic Nephritis — Suppurative Nephritis — 
Degenerations and Neoplasms of the Kidney — Para- 
sites of the Kidney — Diabetes Insipidus — Diabetes 
Mellitus. 

SECTION X. 

Diseases of the Bladder 90 

Cystitis — Spasm of the Sphincter Vesica — Paraly- 
sis of the Sphincter — Lithiasis; Stone in the Bladder 
— Retroflexion — Tumors — Prolapse — Eversion. 

SECTION XL 

Diseases of the Prostate, Urethra and Prepuce 98 

Urethral Calculi — Urethritis; Catarrhal Inflamma- 
tion of the Mucosa of the Urethra — Prostatitis — Hy- 
pertrophy of the Prostate — Neoplasm; Tumor of the 
Prostate — Phimosis — Paraphimosis — Tumors of the 
Glans, Prepuce and Vagina. 

SECTION XII. 

Diseases of the Testicles and Scrotum 103 

Orchitis — Abcess of the Testicle — New Growths. 

SECTION XIII. 

Diseases of the Heart and Blood Vessels 105 

Pericarditis — Acute Endocarditis — Chronic Endo- 
carditis and Valvular Defects — Hypertrophy and Dila- 
tation of the Heart — Rupture of the Heart. 

SECTION XIV. 

Diseases of the Blood and Blood Vessels Ill 

Aneurysms — Hematozoa — Anemia of the Brain — 
Cerebral Hemorrhage. 

SECTION XV. 

Diseases of the Nervous System 113 

Encephalitis — Cerebrospinal Meningitis — Inflamma- 
tion of the Spinal Cord and Membrane; Myelitis and 
Meningitis Spinalis — Apoplexy — Epilepsy — Chorea. 



CONTENTS 5 

SECTION XVI. 

Diseases of the Eye 122 

Conjunctivitis — Keratitis — Abscess of the Cornea — 
Opacities of the Cornea — Congenital Opacities — Iritis 
— Cataract — Diseases of the Retina — Glaucoma. 

SECTION XVII. 
Diseases of the Ear 131 

Ulceration of the Ear Flap — Catarrh of the 
Auditory Canal (Canker)— Deafness. 

SECTION XVIII. 

Diseases of the Skin 135 

Sarcoptic Mange — Follicular Mange — Ringworm 
and Favus — Parasitic Dermatitis — Non-Parasitic Dis- 
eases of the Skin — Erythema — Eczema — Urticaria — 
Alopecia — Acne. 

SECTION XIX. 

Infectious Constitutional Diseases 148 

Distemper — Rabies — Furious Rabies — Dumb Rabies 
— Tetanus — Anthrax — Tuberculosis — Granuloma. 

SECTION XX. 

Internal Par.vsites and Parasitisms 165 

Spiroptera Sanguinolenta — Ascaris Marginata — 
Oxyuris Vermicularis — Ankylostomum Trigonocepha- 
lum — Tricocephalus Depressiusculus — Tsenia; Tape- 
worms. 

SECTION XXI. 

Poisons and Poisoning 171 

Pathology of Poisoning — Arsenic — Phosphorus — 
Strychnin — Hydrocyanic Acid and Potassium Cyanid 
— Carbolic Acid (Phenol) — Iodoform. 

PART II 

Surgical Operations. 

SECTION I. 

Preliminaries 180 

Anesthesia — General Anesthesia — Preparatory 
Treatment of the Operative Area — Preparation of In- 
struments — Preparation of the Operator's Hands. 

SECTION II. 

Surgery of the Head and Neck 188 

Hematoma of the Ear Flap — Plastic Operation for 
Split Ears — Harelip and Cleft Palate — Esophagotomy 
— Tracheotomy. 



6 CONTENTS 

SECTION III. 

Surgery of the Eye 194 

Injuries; Foreign Bodies — Warts and Foreign 
Bodies — Entropion — Ectropion — Pterygium — Dis- 
placed Orbital Gland — Enucleation of the Eyeball. 

SECTION IV. 

Surgery or the Thorax and Abdomen 203 

Paracentesis Thoracic — Paracentesis Abdominis — 
Paracentesis Vesicse — Laparotomy — GastrotoAiy — 
Enterotomy — Enterectomy and Anastomosis of the 
Intestine — Ovariotomy and Ovariohysterectomy — Hy- 
sterotomy — Cesarian Section — Suprapubic Lithotomy. 

SECTION V. 

Operations for Hernia 275 

Umbilical Hernia — Ventral Hernia — Inguinal 
Hernia — Scrotal Hernia — Perineal Hernia. 

SECTION VI. 

Surgery of the Legs and Tail 279 

Sprains — Dislocations — Necrosis — Amputation of 
the Tail — Fractures — Amputation of • Claws — In- 
terdigital Cysts — Tumors. 

SECTION VII. 

Obstetrics 225 

Dystocia — Maternal Dystocia — Petal Dystocia— 
Accidents Liable to Occur During Parturition Ex- 
haustion — Lacerations of the Vagina — Rupture of the 
Uterus — Sequelae to Parturition — Vaginitis — Pro- 
lapse of the Vagina and Uterus — Metritis — Simple 
Metritis — Septic Metritis or Puerperal Fever — Mam- 
mitis — Eclampsia. 



CANINE MEDICINE AND 
SURGERY 

PART I 
CANINE MEDICINE 

SECTION I 

GENERAL REMARKS 

THE examination of a sick dog must be made 
carefully, so that a correct diagnosis of its 
condition may be reached, as on this the treatment 
and ultimate results largely depend. In this pre- 
liminary examination the animal must be handled 
gently but firmly, and so secured that it can do 
no injury to the veterinarian or to his assistants. 
In every case, unless the animal is known to be 
docile, its jaws should be secured either by a muz- 
zle or by a clove hitch. * The non-observance of 
this precaution has led repeatedly to painful in- 
juries, and in several instances in the writer's expe- 
rience has made necessary a visit to the hospital for 
the Pasteur treatment. 

The physical condition of the patient, and its 
mental attitude, should be noted, and its appetite, 
diet and the condition of the bowels and urinary 
apparatus should be inquired into. The tempera- 
ture, the rate and character of the pulse and the 
respiration should also be noted. The nose of a 
well dog is moist and cool ; in a sick dog it is usu- 
ally hot and dry. The skin, normally, is loose and 
supple, and the hair bright and lustrous ; in disease, 

7 



8 CANINE MEDICINE AND SURGERY 

on the other hand, the skin becomes dry, often 
hot to the touch, and it may be the site of erup- 
tions, and in some places he devoid of hair. In 
wasting disease, skin aihnents and digestive derange- 
ments the hair feels harsh and dry, is staring in ap- 
pearance, and is often brittle or easily pulled from 
the follicles. The condition and color of the visible 
mucous membranes are often valuable guides to 
diagnosis, and should always be examined, while 
the character and amount of any discharge from 
the eyes and natural openings of the body must 
on no account be overlooked. 

Having made this general examination of the 
patient, a more searching and specialized one is 
next carried out. The information obtained by the 
general examination will determine what organ or 
organs it is necessary to examine more closely. 

If the lungs, bronchial tubes or pleurae are sus- 
pected, the special examination consists of ausculta- 
tion and percussion to determine what abnormalities, 
if any, are present. The abdomen should be pal- 
pated, auscultated to determine the absence or pres- 
ence of peristalsis, and moderate pressure applied 
over the abdominal walls to discover any unusual 
tenderness or tenseness of these walls. The eyes 
should be carefully scrutinized, and the action of 
the pupils noted, to learn whether the dilation is 
equal or unequal. 

The writer cannot urge too strongly that through- 
out the examination all gentleness and consideration 
be shown the patient, both for humane and ethical 
reasons, and because of the fact that success in dog 
practice depends in no mean degree upon one's 
ability to "get along" with the mistress of the dog 
and win the confidence of the pet, both of which 
are impossible if the dog is handled roughly during 
the examination. 



ADMINISTRATION OF MEDICINES 9 

THE ADMINISTRATION OF MEDICINES 

Medicine may be administered as to other animals, 
by the mouth, hypodermically, intravenously or by 
the rectum. The first two methods, save in excep- 
tional 'cases, are those uK^st frequently practiced. 

The Oral Method 

Medicine in solution, in emulsion and in pill or 
tablet form may be given orally, but the two latter 
are by far the easiest to administer. To administer 
a pill or tablet the animal is either held by an assist- 
ant or steadied against the operator's legs ; the left 
hard is placed over the upper jaw and the cheeks 
pressed against the teeth, while the under jaw is 
gently depressed by the first finger of the right hand. 
As the movith opens, pressure is maintained by the 
fingers of the left hand, thereby forcing the cheeks 
between the molars and efl^ectually preventing the 
mouth closing. The pill or tablet is then placed 
well back on the animal's tongue and the mouth 
allowed to close. 

In cases where it is desirable to administer the 
medicament in liquid form the dose should be regu- 
lated so as to be of as small a quantity as possible, 
except, of course, where irritant drugs are used, in 
which case they must be properly diluted to avoid 
irritation of the buccal mucous membrane. The 
medicine being already placed in a teaspoon, syringe 
or other convenient receptacle, the animal's mouth 
is closed, either by an assistant holding the jaws 
closely together or by tying them together with a 
tape. The index finger of the left hand is then 
introduced at the corner of the lips and the cheeks 
pulled outwards to form a pocket, into which the 
medicine should be poured slowly until the animal 
has taken the required dose. 



10 CANINE MEDICINE AND SURGERY 

The Hypodermic Method 

This is one of the most effectual methods of 
administration where quick absorption, with con- 
sequently quick results, is desired. The require- 
ments are non-irritating and easily soluble drugs, 
small-caliber needles and a twenty-minim syringe, 
preferably all metal, because such are easily steril- 
ized. The site of injection is of no importance, 
provided the skin be loose and thin, and for this 
reason tbe region of the scapula is generally selected. 
The site of injection should be painted with tinc- 
ture of iodin to disinfect it ; the needle and syringe 
should be sterilized by boiling, and the drug com- 
pletely dissolved in distilled water. Unless all of 
these precautions are taken, an abscess may result 
at the site of the puncture. The syringe being 
filled, the skin is pinched up by the index finger 
and thumb of the left hand, the needle pushed 
quickly through the skin into the subcutaneous tis- 
sues, by the right hand, and the syringe is then 
attached and its contents evacuated slowly. 

The Intravenous Method 

This method is not used extensively in dog prac- 
tice, but is coming more into vogue than formerly. 
The skin over the vein selected for the injection, 
usually the auricular vein, must be most carefully 
disinfected before the needle is inserted. The needle 
and the syringe must also have been sterilized, dis- 
tilled water should be used for the solvent, and the 
drug must be completely dissolved to avoid em- 
bolism with its attendant dangers. The temperature 
of the solution should be raised to the temperature 
of the animal, and great care exercised in introducing 
the needle into the vein. All air must be expelled 



ADMINISTRATION OF MEDICINES 11 

from the syringe before injecting, and the injection 
made slowly. 

The Rectal Method 
Medicine is administered by the rectum chiefly 
in the form of suppositories for the treatment of 
some local conditions, such as hemorrhoids, although 
both ether and chloral may be given by this method 
to induce anesthesia. The rectum is first emptied 
by an enema of warm, soapy water, then the sup- 
pository is introduced manually or the liquid injected 
by means of a syringe. Rectal injections to remove 
feces, to lower temperature and for other purposes 
may also be considered as medication by the rectum. 



SECTION II 

DISEASES OF THE UPPER RESPIRATORY 
PASSAGES 

Simple Nasal Catarrh, Rhinitis, Coryza, Cold in the 

Head 

THIS condition, as the name implies, consists of 
an inflammation of the nasal mucous (schneid- 
erian) membrane. However, it sometimes extends 
to the mucous membrane of the sinuses of the head. 

Cause. — Cold, infection and the inhalation of ir- 
ritant gases and other substances, for example, 
chemical fumes, smoke, dust or pollen are frequent 
causes of this condition. 

Symptoms. — The first symptom noticed is sneez- 
ing and pruritus of the nose, the animal trying to 
alleviate the itching by pawing at the nose or trying 
to rub it against something. The nose is hot and 
dry and the nasal mucous membrane hyperemic. In 
from twelve to twenty-four hours exudation from 
the mucous membrane takes place and a thin and 
watery discharge is established. This later becomes 
thicker and more tenacious, taking on a purulent 
character. This discharge must be differentiated 
from that of canine distemper, which is more sticky 
and of a greenish-yellow color, besides being nearly 
always of an offensive odor and often streaked with 
blood. The duration of an attack of nasal catarrh 
is usually about one week. 

Treatment. — Nasal catarrh should always receive 
treatment, since it opens the gates, as it were, to 
other infectious agents; and, furthermore, the 

12 



EPISTAXIS 13 

catarrhal conditions may spread farther down the 
respiratory tract. 

A mild laxative, such as olive oil or cascara ex- 
tract, should be given, and the nose kept clear of 
discharge. Inhalation of medicated vapor gives 
great relief and soothes the inflamed mucous mem- 
brane. A few drops of oil of eucalyptus, creolin 
or Friar's balsam (compound tincture of benzoin), in 
a kettle of boiling water, is all the apparatus re- 
quired for steaming a dog. Small doses of quinin 
bromid, given three or four times daily, are usually 
all the medicine required. Attention must be paid 
to the surroundings, the patient being made com- 
fortable in a warm, dry and properly ventilated 
kennel. The diet should consist chiefly of milk and 
easily digested solid foods. 

Epistaxis 
Bleeding from the nose is usually the result of 
violence, such as a kick or blow ; it may be slight 
or very profuse, according to the extent of the in- 
jury. It is also seen as a symptom in disease of 
the turbinated bones, in neoplasms of the nasal or 
other sinuses of the head, and also in some para- 
sitic affections, such as from the Pentastoma tseni- 
oides and in hookworm disease (Uncinaria trigono- 
cephala infestation). 

Treatment. — The animal must be kept quiet, and 
cold, either in the form of cold water or ice packs, 
should be applied over the nasal sinuses. Spraying 
the nostrils and nasal mucous membrane with a 
1-lCOO solution of adrenalin chlorid will usually 
control the hemorrhage. However, in case the 
hemorrhage becomes alarming and fails to respond 
to the foregoing treatment, a full physiologic dose 



14 CANINE MEDICINE AND SURGERY 

of atropin sulphate should be injected hypo- 
dermically. 

Laryngitis 

The most common cause of laryngitis is cold. 
The usual way the animal becomes affected is by 
lying near a hot stove or a fire until he is too warm, 
and then lying by a door where a cold draught 
strikes the neck. Constant barking, a habit of dogs 
when away from home, is another prolific cause. 
External injuries to the larynx, caused by the dog 
straining at the leash or the jerk-line being applied 
too vigorously by the dog trainer while training 
animals to the gun, are likewise considered among 
causative factors. 

Laryngitis may also appear as a complication in 
distemper or in bronchitis. 

Symptoms. — A cough is the first symptom of 
laryngitis. This may be quite violent, and at first 
is hard, harsh and dry. When exudation takes place 
the cough becomes moister and softer. Auscultation 
over the larynx reveals wheezing or rattling sounds ; 
manipulation of the larynx is painful, producing an 
attack of coughing. The cough is also easily excited 
and aggravated by running, eating, drinking and by 
the administration of drugs. In severe cases, where 
the mucous membrane is much swollen, there is a 
well-marked difficulty in respiration ; the tempera- 
ture runs high, to 104 or 105 degrees Fahrenheit, 
and the appetite is impaired. 

The average duration of an uncomplicated attack 
of laryngitis is about four days, when, if not relieved, 
it may run on into the chronic form, or sudden death 
may occur from edema of the glottis. 

Treatment. — The animal must be immediately 
placed in warm and comfortable quarters, and an 
abundance of cold water provided and kept con- 



LARYNGITIS 15 

stantly before him. According to the situation and 
circumstances, antiphlogistin (cataplasma kaolini 
U. S. P.), hot applications constantly renewed, a 
Priessnitz compress,* or the ammoniacal liniment 
(B. T.), must be applied over the region of the 
larynx. 

The throat should be sprayed three or four times 
daily with an antiseptic solution, such as equal 
parts of listerine and water, or one dram tincture 
of iodin in one pint of normal saline solution. To 
control the cough administer codein sulphate in 
doses of from one-fourth grain to two grains, ac- 
cording to size and weight of dog. Glycoheroin 
(Smith) in teaspoonful doses is useful, as are also 
some of the preparations of heroin and codein now 
on the market. Where edema of the glottis threatens, 
guaiacol should be given and pushed to effect ; 
tracheotomy should not be delayed if there are symp- 
toms of impending suffocation. The following pre- 
scription has been used with success : 

B Guaiacolis dr. i 

Glycerin! dr. ii 

Spts. vini rect oz. iv 

M. Sig. Give half a teaspoonful in four teaspoonfuls of 
water three times daily. 

Chronic Laryngitis 

This condition usually results from an acute at- 
tack or from some other grave respiratory disorder. 
It may also be caused by new growths, or it may 
be tuberculous. Except as a sequel to the acute 
form, the approach of chronic laryngitis is gradual 
and unaccompanied by constitutional disturbances 
other than those produced by the conditions of 
which it is a complication. 



*Foi- a description of tlie Priessnitz compress or bandage, see 
the footnote on page 48. 



16 CANINE MEDICINE AND SURGERY 

Symptoms. — The manifestations of chronic laryn- 
gitis are the same as of the acute form, but are 
much modified in intensity. The cough is not so 
easily excited, but is hard and dry, and is usually 
worse at night, being often of a spasmodic nature. 
On manipulation, the larynx is not so tender as in 
the acute form of the disease, though coughing can 
be produced by pressure upon it. Exercise and 
excitement likewise produce attacks of coughing, as 
does also exposure to cold winds or draughts. 

Treatment. — This, as a rule, is not satisfactory, 
but should consist of sedatives, to allay the cough, 
and stimulant inhalations, such as steam medicated 
with turpentine or oil of eucalyptus. Medicinally, 
guaiacol in oil may be given, and the patient should 
be placed on a good tonic course and liberal diet. 
A sharp counterirritant over the laryngeal region 
is also of benefit in some cases. 



SECTION III 

DISEASES OF THE BRONCHI AND LUNGS 
Bronchitis 

THIS affection is quite common ; it consists of 
a catarrhal inflammation of the bronchial mu- 
cous membrane, and occurs both in the acute and 
chronic form, which see. 

Acute Bronchitis 

Acute bronchitis may be due to any of the fol- 
lowing causes : Infection ; exposure to cold and 
wet draughts when warm from exercise, or from 
lying in front of a stove or fire ; smoke, chemical 
fumes (inhalation bronchitis), medicines going "the 
wrong way," particles of food inspired when the 
animal is insensible, parasites, ether anesthesia, and 
as a complication of distemper. 

The average duration of an attack of acute bron- 
chitis is from two to three weeks. 

Symptoms. — This disease is ushered in with 
shivering fits or rigors, and a rise of temperature 
to 103 or 105 degrees Fahrenheit. The animal is 
depressed and more or less indifferent to its sur- 
roundings ; the bowels are costive ; the urine highly 
colored and scanty. Soon a cough appears, at first 
dry and dull, but later, as the disease reaches the 
second stage, moist and loose. The cough can be 
quite easily excited by pressure on the thoracic walls 
behind the shoulder or by slight pressure on the 

trachea. At first only the large bronchi may be 

17 



18 CANINE MEDICINE AND SURGERY 

affected, but if the condition extends to the capil- 
lary air passages the above symptoms are much inten- 
sified. The respirations are quickened and labored, 
and the cheeks puff out at each expiration ; the 
fever runs higher and the depression and general 
constitutional disturbance become more marked. 
The pulse at first is full and bounding, then becomes 
quicker and weaker, and in cases approaching a 
fatal termination is almost imperceptible. Percus- 
sion gives negative results. In the first stage, 
auscultation reveals that the respiratory sounds are 
harsh and dry (bronchus rale) ; in the second stage 
the mucous rale is well established, and the vascular 
murmur intensified. An attack lasts two to three 
weeks, and ends in recovery, chronic bronchitis, 
catarrhal pneumonia, stenosis, or asthma. 

Treatment. — In smooth-haired dogs the thorax 
should be covered with a coating of cataplasma 
kaolini U. S. P. (or antiphlogistin, thermofuge, or 
similar remedy), applied hot, and covered with a 
thick covering of cotton wool, kept in place either 
by a bandage or by a pneumonia jacket, which can 
easily be made from factory cotton quilted with 
cotton wool or batting. This application should be 
removed and reapplied every twenty-four hours, for 
two dressings. In animals covered thickly with 
hair, oil of Sinapis, one part, and olive oil, forty 
parts, well rubbed in, should be substituted for the 
cataplasm, and the jacket applied as before. 

A purgative is always indicated in acute bron- 
chitis, and may consist of one half to two grains of 
calomel, repeated as occasion requires, it being most 
important to stimulate elimination from the outset 
of the disease. Unless the disease is of the well- 
marked sthenic type and the fever extreme, the 
coal-tar antipyretics, such as phenacetin and anti- 



BRONCHITIS 19 

pyrin, should be sedulously avoided, on account of 
their depressing action on the heart. The fever may 
be kept within bounds and elimination obtained far 
better by febrifuges and diuretics. The following 
is a satisfactory combination : 

IJ Potassii acetatis grs. xv 

Liquor ammonii acetatis dr. i 

Spiritus etheris nitrosi min. xxx 

Infusion buchu drs. iv 

M. Give four drams without water twice daily. 

The cough may be regulated by one-fourth-grain 
doses of codein sulphate every hour. 

In the second stage an expectorant cough mixture 
should be given, and stimulants as needed, of which 
there is none better than 1-200 to 1-60 grain of 
strychnin. Either of the following prescriptions 
may be used with good results : 

IJ Heroin hydrochloridi gr. i 

Syr. tolutani, 

Syr. scillse, aa . . . , drs. vi 

Aquae cliloroformi ozs. vi 

M. Give two to four drams in water three times daily. 

IJ Vini ipecacuanhae min. xii 

Liquor ammonii acetatis, 

Syr. codeinae dr. ss 

Syr. scillae, aa min. xv 

Aquae ad drs. iv 

M. Give four drams three times daily. 

Should the bronchial tubes become loaded with 
mucus of which they are not able to rid themselves, 
and the animal's breathing becomes greatly dis- 
tressed because of its interference with the passage 
of air, an emetic, of which the most effective is one 
thirtieth to one-tenth of a grain of apomorphin 
hydrochlorid, will give great relief, often averting 
suffocation. 

The after-treatment consists of a liberal diet and 



20 CANINE MEDICINE AND SURGERY 

tonics, such as Blaud's pills, one pill three times a 
day, or a granule composed of 

R Strychnin arsenate gr. 1-128 

Iron arsenate, 

Quinin arsenate, aa gr. 1-64 

Nuclein solution min. iv 

M. Give one half to three, three times daily, or give ferri 
et quininge arsenas, two to ten grains, three times daily. 

Chronic Bronchitis 

This is a sequel to cases of acute bronchitis which, 
owing to neglect or other reasons, merge into the 
chronic. It runs a varied course of from a few weeks 
to several months. 

Symptoms. — Continual coughing and expectora- 
tion is a symptom of chronic bronchitis. The cough 
is easily started by exertion or excitement, and the 
expectorated matter is tenacious and often of an 
offensive odor. The pulse and temperature as a 
rule are disturbed but little, although in some cases 
the latter may be slightly elevated. The animal's 
appetite is variable, and it generally loses flesh and 
becomes more or less emaciated. 

Treatment. — The treatment consists iti controlling 
the cough and the exhibition of expectorants, steam- 
ing with stimulating medicated inhalations, and the 
administration of tonics. 

In this condition "Guaialyptol," a combination of 
guaiacol, eucalyptus, camphor, and phenic acid in 
oil has a markedly beneficial effect upon the mu- 
cous membrane and disinfects the entire respiratory 
tract. Cod-liver oil is also a most valuable re- 
constructive and should be given a trial. A liberal 
diet must be prescribed, and, as in all diseases 
of the organs of respiration, the importance of 
proper hygienic conditions must not be overlooked. 



PNEUMONIA 21 

Pneumonia 

Like bronchitis, inflammation of the substance of 
the lungs is due to infection (pneumoccoccus, or 
Diplococcus ])neumonice, and various Streptococci 
and Micrococci). It may also be caused by the 
spread of inflammation from other parts, as from 
the bronchial tubes in bronchitis or from the pleura 
in pleurisy. Again, it may be developed by the 
direct action of mechanical or other irritation, such 
as the inhalation of irritant gases or dust, or by 
vomition ; or it may spring from the presence of 
emboli in the branches of the pulmonary artery or 
Oi' tubercles or clots in the lung tissue ; it may 
also occur as a complication of heart disease, kid- 
ney disease, rheumatism, debilitating diseases, dis- 
temper, tuberculosis, or echinococcosis. 

Cold and wet, unhealthful surroundings, and a 
lowered vitality are undoubtedly predisposing 
causes. Clinically, in the dog we have to deal with 
two forms of pneumonia, namely, lobar pneumonia, 
which is of rare occurrence, and lohidar pneumonia, 
which is common. The words "dififuse" and "cir- 
cumscribed," however, might be used to better ad- 
vantage, the type of the former variety being fur- 
nished by the idiopathic affection ; that of the latter 
by the condition which is secondary to diseases of 
the air passages. The two varieties, however, 
merge into one another. 

Lobar (Croupous) Pneumonia 

This type begins with hyperemia of the small 
vessels which are distributed in the walls of the air 
cells and bronchial passages, a swelling and tend- 
ency to proliferation of the epithelial cells of these 
parts, and an exudation of serum and cellular ele- 
ments of the blood. The air vesicles and passages 



22 CANINE MEDICINE AND SURGERY 

communicating with them gradually become filled 
and finally distended with this exudate, the air in 
them is expelled or absorbed by degrees, and the 
affected lung tissue becomes solid and heavy. If 
the parts be now examined microscopically, the 
dilated blood vessels will be found crowded with 
their corpuscular contents, and the alveoli full of 
cells, all blended together into a common mass 
either by an amorphous, glutinous cement, or by 
a delicate, fibrillated network. With the progress 
of the disease the contents of the air vesicles 
liquefy and acquire a purulent character. This 
liquefied exudate is removed partly by expectora- 
tion and partly by gradual absorption. Occasion- 
ally, however, this breaking up of the exudate is 
followed by a breaking down of the lung substance, 
abscess formation, and gangrene. 

The progress of a case of pneumonia through its 
various phases is quite gradual, but there are at 
least three stages that are more or less well 
marked. The first of these is the stage of en- 
gorgement (congestion, hyperemia), the second that 
of red hepatization, the third that of gray hepatiza- 
tion. In the first stage the lung still contains air, 
though in diminished quantity; it is deeply con- 
gested, exudes more moisture than is natural, is 
increased in weight, and is more friable than nor- 
mal lung tissue. This condition of the lung tissue 
is difficult to distinguish from hypostatic conges- 
tion, for whicl^ it must not be mistaken if found 
on autopsy. In the second ^tage the lung is con- 
solidated ; the cells have lost their air and the 
cavities are filled with adherent masses of cells; 
it is distended to its full size, and its constituent 
lobules are distinctly mapped out upon the sur- 
face. In this stage the lung will sink in water 



PNEUMONIA 23 

and when sectioned it appears fairly dry and 
slightly granular, presenting a marbled aspect 
which is due to the intermixture of nearly colorless 
inflamnlatory exifdate and areas of congestion. The 
third stage dififers from the second mainly in the 
assumption by the affected lung tissue of a fairly 
uniform, opaque, grayish, yellowish, or greenish 
tinge, in its largely increased friability, and in the 
ready exudation from the cut surface of a thick, 
turbid, purulent fluid ; in some cases this exudate 
is comparatively scanty ; in others it is so abund- 
ant that the lung is like a sponge saturated with 
pus. Since pneumonia tends to spread, it naturally 
follows that different portions of the affected lung 
often present well-marked differences of condition, 
and that we occasionally find all the recognized 
stages of pneumonia present at the same time in 
the same case. 

Inflammation may involve the lung to a varied 
extent; thus it may be limited to a section no 
larger than a walnut or it may include the whole 
Ipbe or even a whole lung ; and further, it may 
affect both lungs. The right lung is affected more 
frequently than the left, and the lower lobe more 
often than the upper. 

Symptoms. — Although of somewhat rare occur- 
rence, the symptoms of lobar pneumonia should be 
known by the veterinarian. The disease is ushered 
in with a day or two of lassitude and dullness, 
anorexia, and restlessness. The invasion of the dis- 
ease is generally marked by a rigor or a succession 
of rigors, and the temperature rises to 104 or 106 
degrees Fahrenheit; the respirations are increased, 
in some cases up to sixty a minute. The breath- 
ing is shallow and labored and accompanied by 
more or less dyspnea ; the cheeks are puffed out 



24 CANINE MEDICINE AND SURGERY 

at each expiration. There is a short, dry, painful 
cough. The pulse is full and bounding, running 
at the rate of 150 to 190 a minute during the 
hyperemic stage, but becoming softer and weaker 
but still fast in the second and third stages. In 
cases approaching a favorable termination the 
pulse gradually regains its normal tone and rate, but in 
those cases that do not recover the pulse becomes 
weaker and weaker, until it is barely perceptible. 

While pneumonia is in progress the systemic 
veins are apt to become overloaded and the mucous 
membranes may assume a cyanotic tint, although 
usually they are congested and of a reddish color. 
Thirst is always increased, but loss of appetite is 
invariable. The condition of the bowels varies, and 
though the patient is usually constipated, some- 
times there is more or less diarrhea. The urine 
is scanty and dark colored. 

In the first stage of lobar or croupous pneumonia 
the most observable auscultatory phenomenon is 
minute crepitation, which may be audible during 
the whole of inspiration, sometimes during expira- 
tion as well, and not infrecpiently at the end of 
a deep inspiration, such as that which precedes a 
cough. In association with this there may be no 
change or percussion or there may be high-pitched 
resonance. The second stage is marked by the 
supervention over the consolidated portion of the 
lung of cessation of the fine crepitation and the 
develo])ment in its i)lace of well-marked tubular 
breathing ; when, however, the bronchial tubes lead- 
ing to these consolidated areas are completely ob- 
structed there is total absence of respiratory 
sounds. 

When pleurisy is coexistent with pneumonia, as 
is often the case, the friction sound indicative of 



PNEUMONIA 25 

that condition will also be heard. At a later stage, 
when the lung tissue is breaking down or resolu- 
tion is taking place, tubular breathing gives way 
to a sort of coarse crepitation to which the name 
rrcpitdiio redux has been given. This gradually 
passes into the ordinary bronchitic rales. 

The sputum expectorated is of little diagnostic 
value in the dog, as it is almost invariably swal- 
lowed immediately it is coughed up. It is, however, 
at first transparent, very viscid, and tinged with 
blood, later it loses its sanguineous tint and be- 
comes opaque and greenish, acquiring, in fact, a 
mucopurulent character, and then gradually dimin- 
ishes in quantity. In some cases, instead of 
undergoing these changes, which may be regarded 
as the normal changes, the sputum acquires a deep 
purplish or reddish-brown tint, and at the same 
time a more watery consistency. This form of 
sputum has been likened to prune juice and is gen- 
erally the sign not only of increased congestion 
and escape of blood but of the onset of the third 
stage. If attended by a disgusting fetor, it indi- 
cates the onset of pulmonary gangrene. In either 
case, it cannot but be regarded as an unfavorable 
symptom. 

Lobular {Catarrhal } Pneumonia 

This is the commonest pneumonia of the dog. 
In typical cases the lung is studded with pneu- 
monic patches varying in size from that of a pea 
to that of a walnut, each involving one or more 
pulmonary lobules, circumscribed by the interlobu- 
lar connective tissue and. separated from one an- 
other by a network of still crepitant, and, it may be, 
of perfectly healthy lung tissue. The pneumonic 
patches may be in the hyperemic condition only. 
in which case they may not be recognized or may 



26 CANINE MEDICINE AND SURGERY 

present the features of ordinary red or gray hepa- 
tization. 

Further, by an extension of the disease, the 
neighboring diseased areas may coalesce and thus 
extensive tracts of lung tissue become involved. 
Full lobular pneumonia is always secondary to the 
blocking up of "air passages, and especially those 
of capillary size; it may be excited either by the 
gradual extension of the inflammatory process from 
the tubes to the air vesicles, or by the entrance 
into the vesicles during inspiration of the inflamma- 
tory products of the tubes, which then act as irri- 
tants and carriers of infection. 

Closely related to lobular pneumonia is the dis- 
seminated pneumonia due to obstruction of small 
branches of the pulmonary artery, either by em- 
bolism or thrombosis, or in the course of pyemia. 
In these cases, as in the other, the affected areas 
are of small size and limited by the margin of the 
lobules. But there is a greater variety of result, 
especially in pyemia ; in which, while the affected 
areas sometimes present simple hyperemia, or red 
or gray hepatization, they not infrequently are the 
seat of hemorrhage, or undergo rapid suppuration 
or gangrene. 

In all forms of pneumonia, even in such as are 
not of bronchitic origin, there is a tendency to the 
development sooner or later of bronchitis. But 
apart from this there is a marked disposition early 
in the course of pneumonia to the effusion into the 
tubes from the inflamed air cells of a transparent, 
very viscid fluid, uniformly stained with blood and 
containing cells ; and in some rare cases this fluid, 
like that in the air cells whence it is derived, under- 
goes coagulation in the bronchial tubes, which thus 



PNEUMONIA 27 

become tilled to a greater or less extent with casts 
consisting- of coagulated fibrin and cells. 

Fortunately, abscess formation is the exception 
rather than the rule in lobular pneurrionia, the dis- 
ease seldom going beyond the third stage. 

Gangrene seldom occurs in idiopathic pneumonia, 
it being met with chiefly in those cases in which 
the pneumonia is secondary to or complicated with 
some other affection. It is characterized by the 
breaking down of the lung tissue into a fetid, 
dirty, greenish-yellow pulp, and by more or less 
greenish discoloration of the surrounding consoli- 
dated tissue. The gangrenous condition may involve 
either an extensive tract of lung tissue of several 
scattered areas or even a single small patch. The 
complications of pneumonia are pleurisy, bronchitis, 
icterus, and intestinal congestion. It is common to 
find on autopsy the right side of the heart filled 
with a fibrinous coagulum which is prolonged into 
the pulmonary artery (antemortem clot), while the 
left side is contracted and almost empty. 

Symptoms. — The lobular type, the common pneu- 
monia of the dog, attacks its victims insidiously 
during the progress of some other disease, such as 
distemper or bronchitis. Its onset is not usually 
marked by rigors or the violent circulatory dis- 
turbances noted in the lobar form. In patients 
suffering from bronchitis or distemper the super- 
vention of this form of pneumonia may be sus- 
pected by an aggravation of the respiratory dis- 
turbance. The temperature mounts higher, the 
respirations are more labored, and the puffing out 
of the cheeks at each expiration more marked. 
Auscultatory and percussive phenomena are not so 
distinctive as in the idiopathic form, but apart from 
its insidious approach, longer course, and greater 



28 CANINE MEDICINE AND SURGERY 

mortality, lobular pneumonia, with the exception 
noted, presents the same clinical symptoms as the 
idiopathic variety. 

Treatment. — The treatment of pneumonia of either 
the lobar or lobular type, resolves itself into the 
treatment of conditions found, and the upkeep of the 
vital forces of the patient until the disease runs its 
course. 

The most modern method of treating pneumonia 
is by the pneumobacterin and antipneumococcic 
serum. The former combats the disease by raising 
the opsonic index of the patient, thus enabling the 
leukocytes to more effectually cope with the in- 
vading organisms (active immunity), and should 
be employed as soon as the diagnosis of pneumonia 
is positive. It may be used in doses corresponding 
to those used in human practice, namely twenty- 
five to fifty million dead bacteria injected hypoder- 
mically. It is not necessary to obtain the opsonic 
index, as variations in the temperature constitute 
a sufficient clinical guide. In cases responding to 
bacterin treatment the temperature will fall after 
the injection and then gradually rise again, when 
another injection should be given. The antiserum 
is used to neutralize the toxins already liberated 
by the organism and often produces great ameliora- 
tion of the symptoms (passive immunity). 

One of the most important factors in treating 
this, or for that matter, any other infectious dis- 
ease, is to secure free elimination for both the 
toxins produced by the infecting agents, and also 
for those manufactured in the animal's own ali- 
mentary canal. In health these toxins are elimi- 
nated or neutralized, and their producers kept under 
control by the excretory organs and digestive 
juices. In disease, on the other hand, the functions 



PNEUMONIA 29 

of the excretory organs and, in fact, the whole 
mechanism of the body, is more or less interfered 
with and thrown out of its normal equilibrium. 
In other words, we have to deal not only with 
toxins produced by the invading organisms, but 
with toxins produced by the animal itself, that is, 
with an autointoxication. 

Thus free elimination, both by the intestinal 
tract and the kidneys, must be maintained as the 
most essential part of the treatment. This may 
be accomplished by small doses of calomel, one- 
fourth grain every two hours to effect, or until one 
to two grains have been taken, and by the diuretic 
mixture given for the treatment of bronchitis. 
Constipation must never be allowed to persist. 

In sthenic cases, with a full, bounding pulse, 
the circulation must be equalized either by bleeding 
or, better still, by small, repeated doses of 1-1600 
to 1-800 grain of aconitin every thirty minutes to 
effect, and then at intervals sufficient to keep the 
pulse within bounds. 

The same application to the chest wall as given 
under bronchitis should be applied, or equal parts 
of guaiacol and camphorated oil rubbed in and 
the thorax covered with a padded jacket. Abundance 
of fresh air should be allowed. The cough may be 
controlled by the administration of codein, one 
fourth grain as required, and expectoration facili- 
tated by inhalations and expectorant mixtures. 
Guaiacol is an extremely useful drug in this con- 
dition, being an antipyretic, stimulant, and respira- 
tory disinfectant. 

In the second and third stages an ever-watchful 
eye must be kept on the heart, and stimulants given 
as conditions indicate. Strychnin, 1-200 to 1-60 
grain, is the drug most useful here, and it may be 
advantageously combined with 1-50 grain of digi- 



30 CANINE MEDICINE AND SURGERY 

talin. Throughout the illness the diet must be 
light, nourishing, and easily digested. Milk, beef 
tea, and small quantities of finely chopped raw beef 
are appropriate articles of diet. In cases where the 
animal refuses to eat at all, extract of meat, made 
into pills, may be administered, or a teaspoonful 
each of brandy and beef tea may be given every 
two hours. 

The after-treatment of pneumonia consists of 
liberal diet, moderate exercise, and a good, iron 
tonic. 

In cases of pneumonia that take on a septic char- 
acter due to secondary infection (pyogenic bac- 
teria), all the usual symptoms are accentuated, 
there is the addition of great prostration, and the 
case only too often ends fatally. However, anti- 
streptococcic serum in full and repeated doses has 
in many cases saved life, and should be resorted 
to as soon as the secondary infection is diagnosed. 
Subcutaneous injections of camphor are particu- 
larly useful in these cases and should be repeated 
as required. Thirty to sixty minims of spirit of 
camphor may be given, or it may be given as fol- 
lows: 

R Camphorae grs. xv 

Etheris sulphurici dr. ss 

Olei olivae drs. ii 

M. Inject fifteen to thirty minims, according to the cir- 
cumstances. 

Gangrene of the lung is often the sequel of the 
secondary invasion in pneumonia and is nearly 
always fatal, but the above treatment should be 
persisted in, in the hope of inducing a favorable 
termination. 



SECTION IV 

DISEASES OF THE PLEURA 

Pleurisy 

(Inflammation of the Pleura; Pleuritis) 

The disease is found in two forms, primanj and 
secondanj pleuritis. The primary form is usually 
caused by exposure to cold, especially when the 
coat is wet, as in sporting dogs after swimming, or 
running through wet underbrush. Secondary 
pleurisy appears as a complication of other dis- 
eases, such as pneumonia, pericarditis, peritonitis 
(extending from the abdominal cavity through the 
diaphragm), fractured ribs, punctured wounds of 
the thorax, perforation of the esophagus by for- 
eign bodies, tuberculosis, or pyemia. 

Morbid Anatomy. — The pleura is dull and tume- 
fied and very hyperemic. Its surface is roughened 
by accumulations of fibrin and in appearance may 
be likened to the surfaces of two pieces of bread 
and butter that have been placed together and 
then separated. When there is no accumulation of 
fluid it is termed dry pleurisy, or pleuritis fibrinosa. 

Usually, however, exudation takes place and an 
accumulation of a serous fluid in which fibrinous 
coagula float, is found between the pleural folds. 
This pleuritic fluid, closely resembling blood serum, 
contains cells, and, according to the number of red 
blood corpuscles it contains, is of a straw color or 
of a sanguineous color. 

In secondary pleuritis, infection with pyogenic 
organisms may take place and then the fluid be- 

31 



32 CANINE MEDICINE AND SURGERY 

comes purulent, constituting the condition known 
as septic pleuritis or empyema. In primary pleur- 
itis the condition as a rule affects only one side of 
the chest, while in secondary pleuritis it affects 
both sides, but this is no hard and fast rule. 

The prognosis in primary pleuritis is generally 
favorable, though convalescence may be slow ; that 
of the secondary variety depends entirely on the 
primary cause, or trauma. 

Symptoms. — Pleurisy may or may not be ushered 
in by rigors, but there is always malaise and great 
stiffness in action, and disinclination to move or 
bend the body, the condition being very painful. 
The respiratory movements are painful and almost 
entirely abdominal, the animal, on account of the 
pain attending thoracic movement, trying to fix 
the chest walls as much as possible. The constitu- 
tional disturbance is great, thirst is greatly in- 
creased, anorexia generally complete ; the bowels 
are costive ; the urine is scanty, highly colored, and 
contains albumin ; the pulse is fast and wiry, the 
temperature 104 to 105 degrees Fahrenheit ; the 
mucous membranes are congested. 

Until the effusion has taken place percussion 
yields negative results. Afterwards a dull sound 
is heard up to the level of the accumulated fluid. 

Auscultation reveals the characteristic friction 
sounds of pleurisy, or later the fluid may be heard 
splashing during respiration. Since the accumula- 
tion of fluid in the pleural cavity compresses the 
lung, sometimes to complete collapse, dyspnea is 
always well marked when effusion has taken place, 
and when the effusion is great symptoms of 
asphyxia manifest themselves; the compression of 
the heart and great blood vessels also leads to their 
disturbed and impaired action. 



PLEURISY 33 

\Yhere the effusion is great in amount the inter- 
costal spaces may be seeii to bulge outward and 
the whole side of the chest is thus altered in ap- 
pearance. If empyema supervenes, the pulse be- 
comes rapid and weak, and the temperature is inter- 
mittent but always high. Sometimes, however, the 
first indication of the empyemic condition is the 
expectoration of pus or a pointing in an intercostal 
space ; as the evacuation of the pus in empyema 
must not be delayed, every endeavor should be 
made to diagnose it early. If the presence of pus 
is at all suspected, an exploratory puncture should 
be made.' 

Cough may or .may not be present in pleurisy; 
when present it is always painful, dry and sup- 
pressed. 

Treatment. — At the onset of the disease there is 
hardly any drug that will combat the pain and 
fever and equalize the circulation better than 
aconite or its alkaloid aconitin. Either may be ad- 
ministered in small doses every fifteen minutes for 
two hours, and then hourly, until the effusion takes 
place. The tincture of aconite in two minim 
doses, or 1-800 grain of aconitin, or a defervescent 
compound (aconitin, 1-800 grain ; diditalin, 1-64 
grain; veratrin, 1-128 grain), is perhaps the most 
useful. 

Aconitin, it must be remembered, is a powerful 
drug, and its frequent administration must be 
stopped as soon as either the desired effect is pro- 
duced or the physiological action of the drug 
brought about, as manifested by the softening of 
the pulse, champing movements of the jaws, and 
general relaxation of the patient. When this has 
been attained the dose is given at longer inter- 
vals to maintain the effect. Counter-irritants should 



34 CANINE MEDICINE AND SURGERY 

be applied to the thoracic walls, either in the form 
of cataplasma kaolini, or mustard or oleum sinapis, 
and a firm supporting bandage placed around the 
chest to immobilize the ribs. The relief from pain 
given by thus fixing the ribs is most marked. 

When effusion has taken place, efforts must be 
made to hasten its reabsorption and elimination. 
This may be done by purgatives and diuretics. By 
their alterative and diuretic actions potassium iodid 
or ammonium iodid is of great service here. 
Codein in one-fourth grain doses, repeated as re- 
quired, will control the cough which, if present, is 
always distressing. Where the effusion is so exces- 
sive as to cause great difficulty in breathing, with 
symptoms of asphyxia, paracentesis thoracis should 
not be delayed, but promptly performed. The main 
danger lies in delaying the operation after the 
necessity for it is recognized, the patient's vitality 
then not. being sufBcient for it to recuperate. The 
after-treatment consists in protecting the animal 
from exposure to cold and wet, liberal diet, and 
a line of alterative and tonic treatment. 

Hydrothorax 
(Dropsy of the Thoracic Cavity) 

Hydrothorax, strictly speaking, is true dropsy of 
the chest, although the term has been loosely used 
in connection with the effusion found in pleurisy. 
Hydrothorax is a transudation, non-infiammatory in 
origin, and is the result of some other pathologic 
condition, such as cardiac or renal disease. 

Symptoms. — A gradual filling up of the thoracic 
cavity with the transuded fluid, with corresponding 
difficulty in respiration, is the usual symptom of 
hydrothorax. Percussion reveals a distinct level of 
the fluid in the cavity, parallel to the horizon. 



PLEURODYNIA 35 

The normal respiratory sounds may be heard 
above the level of the fluid, and indistinctly or not 
at all below the level. Splashing sounds are also 
in evidence. The other symptoms will depend upon 
the primary condition. 

Treatment. — Treatment for this disease is usually 
unsatisfactory. • It must first of all be directed to 
the primary disease, and unless this can be diagnosed 
and corrected the treatment of the hydrothorax can 
be only palliative. It consists in the exhibition of 
diuretics and in resorting to paracentesis thoracis. 
This operation is harmless and may be repeatedly 
performed to relieve the dyspnea, but as a rule 
gives no permanent relief unless the primary cause 
is curable. On the other hand, by its repeated per- 
formance the life of an old favorite may often be 
prolonged for a considerable time. 

Pleurodynia 

Pleurodynia is essentially rheumatism of the mus- 
cular walls of the thorax. This exceedingly pain- 
ful condition might possible be mistaken for pleurisy 
unless a careful examination is made. It is due 
undoubtedly to exposure to wet and cold, more 
especially in rheumatic subjects. 

Symptoms. — The animal is dull and listless, and 
evinces pain on movement and upon being handled. 
The breathing is shallow and abdominal, the patient 
trying to use his respiratory muscles as little as 
possible. When compelled to move, the animal 
shows great stiffness and disinclination to bend the 
body. The pulse may be a little more rapid than 
normal, but has not the wiry characteristic of the 
pulse in pleurisy. The temperature, as a rule, is 
about normal, or a little above it. Auscultation and 
percussion reveal nothing. 



36 CANINE MEDICINE AND SURGERY 

Treatment. — Counterirritants to the affected mus- 
cles, capsicum linament or mustard, and the appli- 
cation of the padded pneumonia jacket should be 
resorted to. The region on each side of the spine 
should be palpated, and spots tender to pressure 
should receive smart counterirritation. The patient 
should receive a saline laxative, such as one to 
four drams of magnesium sulphate, Its head being 
kept elevated for twenty minutes after its admin- 
istration to prevent it being vomited, and acetyl 
salicylic acid in doses of five to fifteen grains. 
Asperin (acetyl salicylic acid) is far superior to the 
ordinary salicylates, because it is soluble only in 
an alkaline medium and it does not cause the gas- 
tric disturbances that other salicylates cause. 
Bryonin, 1-20 to 1-40 grain, every two to six hours, 
will usually give prompt relief. 

In addition to the medical treatment, the patient 
must be kept in a warm, dry kennel and not ex- 
posed to cold or wet. The diet should be of a light 
and easily digested nature, such as milk, oatmeal 
porridge, or dog biscuit, while meat should be with- 
held until the attack is over. 



SECTION V 

DISEASES OF THE MOUTH, PHARYNX, AND 
ESOPHAGUS 

Stomatitis 

STOMATITIS, or inflammation of the buccal 
mucous membrane, is the result of either chem- 
ical, thermal or mechanical irritants, and is often 
a complication or symptom of some other disease 
or condition. It is also common during teething, 
and where there are decayed teeth. 

Symptoms. — The patient is observed to be slow 
and careful in eating, large pieces of food being 
discarded and smaller portions bolted without mas- 
tication. Salivation is a prominent symptom, the 
saliva hanging out at the corners of the mouth in 
glairy strings. Upon examination the mucous mem- 
brane of the mouth will be found to be red, swollen, 
and inflamed, the amount of inflammation depend- 
ing on the cause. In the case of corrosive poisons 
having been taken into the mouth the mucous mem- 
branes may be greatly eroded and hanging in 
shreds, the gums and tongue are also inflamed and 
tender, and ulcers sometimes appear on different 
parts of the mouth. 

Treatment. — The dog's diet must consist of bland 
and non-irritating liquids or mashes, such as soups, 
milk, beef tea, bread and milk, and boiled rice ; 
plenty of cold water should be supplied constantly. 

The mouth should be kept clean by means of 
antiseptic and mild astringent washes, applied either 
with a camel's-hair brush or an atomizer ; decayed 

37 



38 CANINE MEDICINE AND SURGERY 

and loose teeth must be removed and the tartar 
cleaned from the remaining teeth. In teething, the 
inflamed gums may be lanced. 

Any of the following solutittns constitutes a useful 
mouth wash for this 'condition : 

1. Potassium permanganate. one-i)er-cent solution. 

2. Peroxid of hydrogen, one to five parts water. 

3. Borax. 130 grains; sodium bicarbonate, 130 
grains; carbolic acid, twenty-five grains; glycerin, five 
one-half drams, and water to make twenty fluid 
ounces. 

Ulcers may be touched with tincture of iodin or 
a strong solution of alum. The tender gums may 
be painted with a tincture of myrrh, or one part 
tannic acid to four parts glycerin. 

Stomatitis Ulcerosa, or Necrotic Stomatitis 

This condition is a necrotic inflammation of the 
mucous membrane of the mouth. It attacks the 
gums more frequently than other parts. 

Cause. — This serious condition is generally seen 
in old, debilitated dogs and in weakly, anemic, and 
pampered animals of all ages. It is usually associ- 
ated with decayed teeth, and is no doubt due to 
some microorganism, probably the Bacillus necro- 
phorus, or possibly to various organisms. It is 
possible that the "Black Tongue" of the Southern 
states is a modified (intestinal), type of this same 
infection. 

Symptoms. — The gums in the neighborhood of 
certain teeth become swollen, red, and painful to 
the touch. In a day or so there is marked increase 
of the swelling, and the aft'ected gum is of a dark 
red, brown-red, or of a purplish hue, while the tis- 
sue affected is spongy, bleeds on the slightest pres- 
sure, and is seen to have receded from the teeth. 
Later, beginning with the swollen region next to 



STOMATITIS 39 

the teeth, the affected part takes on a yellowish 
or greenish-yellow color. This necrotic tissue is of 
a pulpy, greasy consistency, and if removed, either 
by the sloughing i)rocess or by force, leaves a 
large ulcer about one sixteenth of an inch deep, 
with irregular, ragged edges. 

The walls of the ulcer are hard and hyperemic 
and raised above the general surface of the gum. As 
the gangrenous process prcx'eeds. abscesses form in 
the alveolar process, and the teeth become loose 
and fall out ; in extreme cases, the jaw itself may 
become necrotic and portions of the bone exfoliate. 

The morbid process extends from the gums to the 
lips and to the cheek, corners of the mouth, anl 
in rare cases to the tongue. There is always a 
profuse salivation, the discharge being ropy, glairy, 
blood-stained, and of an intolerably fetid odor. 
There is usually a rise of temperature to 103 degrees 
Fahrenheit, or even higher if septic absorption takes 
place, in which case the patient usually dies of 
septicemia. 

The appetite is generally good, although mastica- 
tion is both painful and difficult. In cases that run 
a benign course the necrosis is usually confined to 
the mucous membrane, and after the separation of 
the slough, the ulcers heal rapidly, often l^eing entire- 
ly well in from eight to ten days. In the case of old, 
debilitated subjects the disease more often assumes 
a malignant type, the gangrenous and necrotic proc- 
esses extend rapidly, and the animal dies from 
septic absorption. 

Treatment. — All loose and decayed teeth must 
first be extracted and abscesses evacuated. The 
mouth must be frequently swabbed with a deodorant 
mouth wash, such as potassium permanganate in 
one-per-cent solution or hydrogen peroxid, and after- 



40 CANINE MEDICINE AND SURGERY 

wards strong disinfectants applied. Creolin in two- 
per-cent solution, painted on with a camel's-hair 
brush, is most effectual. Lugol's solution* of iodin 
applied in the same manner often gives good re- 
sults, and touching up the ulcers with caustics is 
also effective. Internally the patient should receive 
an occasional laxative and an iron tonic. Nuclein 
(eight minims hypodermically twice daily) should 
be given from the beginning of the treatment, and 
the animal's strength kept up by a liberal and' easily 
digested diet. 

Glossitis 

Inflammation of the tongue is usually the 
result of injury by foreign bodies becoming em- 
bedded in or lacerating the substances of the tongue. 
Among the common causes of this condition may 
be mentioned spicules of bone that become lodged 
between the molar teeth, elastic bands placed around 
the tongue either by children in play or by some 
malicious person, irritant medicines, and caustics, 
new growths (carcinoma, sarcoma), etc. 

Symptoms. — The animal shows difficulty in mas- 
tication and in lapping water. Salivation is pres- 
ent, the tongue is red, swollen, and tender, and the 
breath is often oft'ensive. 

Treatment. — A careful examination of the tongue 
must be made for foreign bodies, which, if present, 
must be removed. The teeth must also be examined 
for particles of bone wedged between them, and if 
any are found they must be removed. Wounds of 
the tongue heal with remarkable rapidity, and often 
the removal of the cause and the use of some mild 
antiseptic mouth wash complete the cure. 



*Lugors solution consists of: Iodin 5 parts; potassium iodid 10 
parts; water q. s. 100 parts. 



EPULIS 41 

Ranula 

Ranula is a large, fluctuating swelling which ap- 
pears at the lateral or under surface of the tongue, 
usually near the frenum. It is painful, produces 
profuse salivation, and may attain such size as to 
prevent the complete closure of the mouth. 

Cause. — This trouble is due to the blocking up 
or closure of the mucous gland and the consequent 
enlargement of the gland. An obstruction of Whar- 
ton's duct sometimes produces a similar condition. 
The contents of ranulas are of a thick, glairy, 
mucoid nature. 

Treatment. — This should be surgical, the instru- 
ments required are a mouth speculum, a small 
scalpel, scissors, and tissue forceps. The instrument 
having been sterilized by boiling for twenty min- 
utes, the mouth is fixed open with a mouth specu- 
lum and the tongue drawn into such a position as to 
place the ranula in the most suitable situation for 
removal. The sac is then punctured with the 
scalpel and the whole of the wall dissected out ; 
unless this is thoroughly done, the ranula will recur. 
After-treatment consists in washing out the wound 
three or four times a day with an antiseptic and 
astringent mouth wash. Boracic acid, ten grains to 
the ounce, and chinosol, one-half grain to the ounce 
of water, make useful antiseptic washes. 

Epulis 

This name is given to a hard, smooth, periosteal 
tumor which appears on the gums at the edge of 
the alveoli. There may be only one tumor, or they 
may be numerous, and may be benign or malig- 
nant in character. Unless these tumors cause pain 
and undue inconvenience in eating it is better not 
to interfere with them. If an operation is decided 
upon, they may be removed with a scalpel or scis- 



42 CANINE MEDICINE AND SURGERY 

sors and the hemorrhage controlled by styptics. 
Occasionally a bony attachment may be found, in 
which cases bone forceps will be necessary to com- 
plete their removal. 

Papilloma or Wart 

Papillomas are often multiple, and may cover 
nearly the entire surface or the mucous membrane 
of the lips. 

Cause. — These tumors are of infectious origin. 

Treatment, — In many instances papillomas disap- 
pear spontaneously without treatment, and the' ani- 
mal is immune against a second infection. Where 
they are very numerous, local applications of a satu- 
rated tannic-acid solution should be applied and 
Fowler's solution given internally for at least a 
month before resorting to surgical means. If, how- 
ever, there are only a few tumors present, or the 
above treatment is futile, they may be removed by 
ligature or with the thermo cautery. It is best not 
to excise them with the scalpel or scissors, as the 
blood may infect a new area. 

Tumors of the Mouth 

The new growths met with in the mouth and 
pharynx of the dog are mostly carcinoma, sarcoma, 
and adenoma. Usually they are found afifecting the 
soft palate, the pharynx, and the vicinity of the 
tonsils, sometimes even invading the eustachian 
tubes. The cause of new growths is unknown. 

Symptoms. — At first the patient shows some diffi- 
culty in swallowing, and the appetite may be capri- 
cous. Upon examination the growth may be dis- 
covered or, if deep seated, an unhealthy looking 
ulcer with ragged edges may be seen. This may be 
mistaken for an injury caused by a bone or some 
other foreign body, but the involvement of the 



TEETH 43 

neighboring lymphatic glands and the non-response 
to treatment in time reveal its true character. The 
diagnosis may be absolutely confirmed if a small 
portion be excised and submitted to an expert 
pathologist for microscopic examination. In all 
cases there is rapid emaciation, and sooner or later 
death relieves the sufferer. 

Treatment. — There is no successful treatment for 
this condition. Surgical interference appears to 
stimulate the malignant properties of these neoplasms, 
and the most humane course, once the diagnosis of 
malignancy is positive, is to end the animal's suffer- 
ing by an overdose of chloroforni. 

Harelip and Cleft Palate 

These congenital malformations may occur con- 
jointly or singly, and are serious defects. More 
especially is this true of the latter, as it is impos- 
sible for the puppy to feed in the natural way and 
it has to be fed from a feeding bottle with a nipple 
large enough to reach to the back of the mouth. 

A harelip may be double or single. A cleft 
palate may be wide or narrow, existing either in 
the anterior or posterior portion of the mouth, ot 
it may extend the whole length. 

Treatment. — The treatment is surgical, and con- 
sists of scarifying the edges of the lips or palate 
and uniting them by sutures. The details of this 
operation are gi\'en in Part II (see page 191). 

The Teeth 

The dog has forty-two teeth, formulated thus: 
i. 3-3 c. 1-1 pra. 4-4 m. 2-2 = 42 





3-3 




1-1 




4-4 


3-3 






T.\( 


ISOItS 




c. 


^XIXKS 


I'ltEMoI.AItS 


MOLAUS 


JAW. 


r. 


1. 




r. 


1. 


r. 1. 


r. 1, 


Upper . 


....3 


3 




1 


1 


4 4 


2 2 


Lower . 


...3 


3 




1 


1 


4 4 


3 3 



44 CANINE MEDICINE AND SURGERY 

The first incisors and the canines, and the second, 
third, and fourth molars appear in the dog at the 
end of five weeks. The permanent teeth begin to 
appear about the third or fourth month ; the canine 
and middle incisors about the fourth month, and 
the remaining incisors at the end of five months, 
as well as the second, third, and fourth molars, the 
fifth molar about five months, the sixth about the 
sixth month, and the seventh about the end of the 
seventh month. Then the dog has a "full mouth" 
at the end of the seventh month. 

During teething the gums become red and tender 
and the flow of saliva is increased. In some case-3 
the appetite may be entirely suspended and convul- 
sions may occur from reflex nervous irritation. In 
such cases the proper treatment is the administra- 
tion of simple sedatives, such as potassium bromid 
(five grains three times daily), and scarification of 
the gums. 

Tartar 

Tartar is a calcareous deposit on the neck of the 
tooth at the border of the gums. It is deposited 
chiefly around the canine and molar teeth, and 
causes great irritation of the gums, sometimes even 
loosening the teeth and giving the breath an offen- 
sive odor. Tartar should be removed by scraping 
the tooth with a specially constructed instrument 
termed a "scaler," the mouth either ^being closed 
with a tape or kept open by means of mouth specu- 
lum. In powerful, violent patients a general anes- 
thetic may be necessary to facilitate the operation 
of removal. The teeth should then be cleaned with 
a toothbrush and camphorated chalk or other suit- 
able dentifrice. 



CARIES 45 

Caries Dentum 
{Caries of the Teeth) 

True caries of the teeth— that is, molecular de- 
struction — is rare in the dog, but such cases have 
been observed. It begins on the upper surface 
and mainly in the cavity of the crown, appearing as 
a black spot. This spot, which is the decaying part 
of the tooth, gradually penetrates the tooth toward 
the pulp cavity, and finally exposes the nerve, tooth- 
ache being the result. 

In necrosis of the teeth there is usually an alveolar 
periostitis associated with it, the tooth becoming 
loose and yellow^ in color. In these cases alveolar 
abscesses may form and pyorrhea alveolaris, or 
dental fistula, remain. An animal affected with 
toothache becomes irritable, resents any manipula- 
tion of the mouth, has difficulty in mastication, and 
is salivated. The affected tooth is very tender; if 
struck with a sound or key causes the animal to cry. 

Treatment. — In true caries, if treated before the 
nerve is exposed, the tooth may be saved by care- 
fully drilling out the cavity, removing all diseased 
tooth substance, and filling the cavity with dental 
cement or amalgam. If, however, the case has gone 
too far for filling, extraction is the only remedy. 
For this purpose the mouth is held open by a specu- 
lum or gag, the forceps applied as far on the tooth 
as possible, the tooth loosened by a few lateral 
twists and finally extracted by a strong pull in the 
direction of its roots. Immediately after the ex- 
traction the gums should be firmly compressed and 
the mouth washed out with an antiseptic lotion. 



46 CANINE MEDICINE AND SURGERY 

Empyema of the Superior Maxillary Sinus 

Necrosis of the fourth upper premolar often leads 
to empyema of the superior maxillary sinus, into 
which its roots penetrate, the pus discharging by a 
fistula just below the eye. This fistula may heal 
for a time under an antiseptic treatment, but sooner 
or later the discharge is reestablished. By the use 
of a probe and tapping the affected tooth the signifi- 
cance of the fistula is recognized. 

Treatment. — The fourth premolar must be ex- 
tracted, the probe pushed down the fistula into the 
mouth, the sinus syringed out with an antiseptic, 
and free drainage maintained. The syringing is 
continued until healing takes place. 

Pharyngitis, or Sore Throat 

Cause. — Pharyngitis, or inflammation of the mu- 
cous membrane of the pharynx, may be caused by 
the extension or spread of inflammation from con- 
tiguous organs, by irritant medicines and chemicals, 
foreign bodies, or by injuries caused by unskillful 
attempts at removing obstructions lodged in the 
throat or in passing the probang. 

Symptoms. — Pharyngitis is manifested by a some- 
what stifle carriage of the head ; difficulty in swal- 
lowing solids ; sometimes by coughing, especially if 
laryngitis exists also, and by a congested appear- 
ance of the affected mucous membrane. 

Treatment. — The throat must be examined for 
foreign bodies, and if any are found they must be 
removed; this often presents considerable difficulty 
in the case of needles or pins, and great care must 
be exercised to avoid breaking them. The throat 
should then be s])rayed either with iodin solution. 



PAROTITIS 47 

hydrogen peroxid, or Dobell's solution of the fol- 
lowing formula : 

Borax grs. 130 

Sodium bicarbonate grs. 130 

Carbolic acid grs. 25 

Glycerin fl. ozs. 5V2 

Water, q. s fl- ozs. 20. 

The diet must be restricted to liquids and soft 
foods to avoid irritation of the inflamed mucous 
membrane. 

Parotitis 

(Inflammation of the Parotid Gland — Mumps) 

Cause. — There are four varieties of parotitis (or 
parotiditis), the causes of which differ. They may 
be classed as follows : 

Contagious parotitis, the specific organism of 
which has not yet been determined ; traumatic 
parotitis, produced by injuries ; metastatic parotitis, 
due to a metastasis of pyogenic organisms during 
attacks of distemper, pyemia, or septicemia ; and 
parotitis caused by the extension of a neighboring 
inflammatory focus, as in pharyngitis, mastoiditis, 
or similar diseases. 

Symptoms. — In the contagious form the whole 
gland, or both glands, are swollen and tender, but 
there is no tendency to suppuration. In the other 
varieties the swelling is more circumscribed and 
suppuration usually takes places. The swollen 
glands are hot and tender and the act of swallowing 
is difificult and painful. Constitutional symptoms 
are fever, anorexia, and lassitude, while in sup- 
purative cases fluctuation is detected and the fever 
is usually high. 

Treatment. — The patient should receive a mild 
laxative — olive oil or cascara — and the affected 
glands, after being freely fomented with hot water. 



48 CANINE MEDICINE AND SURGERY 

should receive an inunction of warm camphorated 
oil or have calaplasma kaolini applied. 

Moist heat in the form of Priessnitz compresses* 
often gives great relief by lessening the tension of 
the parts, and in cases where abscess formation is 
taking place it hastens the formation of the pus. 
Abscesses should be evacuated, drainage established, 
and the wound treated antiseptically. The diet must 
be of a liquid nature, such as beef tea, milk, and 
soft mushes. ' 

Foreign Bodies in the Esophagus, and Choking 

Choking is caused by the lodgment in the throat 
or esophagus of some foreign body, and is usually 
the result of greediness in feeding. The most com- 
mon foreign bodies are bones, gristle, needles, and 
pieces of wood. 

Symptoms. — The patient is greatly distressed, 

efforts at deglutition are greatly increased, and 

there is a return of food and drink through the 
nostrils. 

Treatment. — Sometimes the offending article may 
be forced back into the mouth by manipulation of 
the exterior parts, and in some cases extraction with 
throat forceps is easy ; but in cases where neither 
of these methods is successful the probang must be 

♦Describing- the Priessnitz bandage or compress and its use, 
Glass says: 

"The object of the compress or bandage is to maintain" a con- 
tinual heat, either dry or moist, to certain parts of the animal's 
body. We first apply to the part affected a piece of absorbent 
cotton, thick wool, or dry felt; or if moisture is required, it is 
soaked in warm water or a medicated solution and wrung out to 
remove the excess of fluid; this is then held in position by a cov- 
ering. of some light material — a wide bandage of cheese-cloth is the 
best — next a layer of oiled silk or rubber cloth (the object of 
this is to retain the lieat and in case of a wet compress, the 
moistin-e), and finally over this is placed a compiess or bandage of 
flannel. This last is to prevent loss of heat li.\- radiation. Some- 
times the inner layer of clieese-clotli is nmittcd. or it ma>' be put 
on the outside of all. 

"The above procedure may seem to the luni'ied practitioner a 
lather long, and unnecessary method, but after one has tried it 
and found tlie great advantages it has in the retention of lieat. 
especially in diseases of lungs, in hastening the maturing of an 
abscess, or in tlie lessening of a tumefaction bv the constant and 
direct application of heat and moisture, he will realize its benefits." 



PAROTITIS 49 

passed and the offending botly cautiously pushed 
on to the stomach. In the case of fish bones or 
needles the operator may be able to entangle them 
in the horse-hair portion of the probang and ex- 
tract them. 

Great caution must be exercised not to use undue 
force or the esophagus may be ruptured, with seri- 
ous, if not fatal, results. Fuller directions for pass- 
ing the probang and for esophagotomy are given 
in Part II, Section II (see page 192). 



SECTION VI 

DISEASES OF THE STOMACH AND 
INTESTINES 

IN the dog, impaction of the stomach and gas- 
tritis constitute about sixty per cent of all dis- 
eases of digestion. This is due mainly to the want 
of proper attention to the animal's diet and to the 
practice of feeding only once a day, whereby the 
animal seeks to satisfy its hunger in a voracious 
manner. 

Impaction of the Stomach 

Cause. — Overfeeding and improper food are the 
principal causes of impaction. 

Symptoms. — Vomiting is an evidence of this trou- 
ble, and if it takes place may empty the stomach 
and so relieve the condition, but in the majority of 
cases vomiting is not violent enough to give much 
relief, and the patient will retch, slaver, and eruc- 
tate gas. Pressure over the epigastric region pro- 
duces pain, the respirations are accelerated, and the 
patient is greatly depressed. There are colicky 
symptoms, with 'great uneasiness and a frequent 
desire to change positions. The animal groans or 
whines, and may be irritable and "snappy." 

Treatment, — Empty the stomach by a hypodermic 
injection of 1-20 to 1-10 grain of apomorphin. 
Enormous masses of undigested or partially di- 
gested food are usually vomited, and relief is almost 
instantaneous. The stomach may then be washed 
out by means of the stomach pump, or eight to 
ten ounces of water may be administered and the 

50 



GASTRITIS 51 

dose of apomorpliin repeated to more thoroughly 
clean the stomach. A gastric sedative, such as 
from five to twenty grains of bismuth subnitrate, 
may then be administered and the animal's diet 
restricted for a week or longer to small (juantities 
of easily digested food. 

Gastritis 

This ailment, due to inflammation of the mucous 
membrane of the stomach, occurs both in the acute 
and the chronic forms. 

Acute Gastritis 

Cause. — Acute gastritis is caused by irritating 
foods or medicines, such as decomposing meat or 
arsenic, corrosive sublimate, or phosphorus, as well 
as by foreign bodies. Acute gastritis also occurs 
as a symptom of distemper. 

Symptoms. — There is vomiting, with little or no 
appetite, and increased thirst, great quantities of 
water sometimes being taken, only to be immedi- 
ately vomited. There is more or less constipation. 
The temperature is raised and the pulse accelerated. 
Pressure on the stomach causes pain. The patient 
is greatly depressed, lying down a great deal and 
assuming an almost diagnostic attitude, by trying 
to rest its abdomen on the floor. 

Treatment. — If an irritant-poison, decayed meat, 
or a foreign body is suspected to be the cause, an 
emetic should be administered to clean out the 
stomach. The vomiting may be controlled with 
from five to twenty grains of bismuth subnitrate. 
combined with three grains of cerium oxalate or 
five grains of chloretone. The constipation may be 
overcome -bv laxatives and enemas. If the j^ain 



52 CANINE MEDICINE AND SURGERY 

indicates it, morphin in one-fourth-grain doses may 
be given subcutaneously, but chloral hydrate must 
never be used on account of its irritating effect on 
mucous membranes. In cases where there is ex- 
cessive tenderness on pressure, warm fomentations 
or turpentine stupes, or even the application of mus- 
tard over the epigastric region, often afford great 
relief. The animal must be kept on a low diet for 
some days ; equal parts of milk and lime water may 
be given, and beef tea or finely minced, raw beef 
in small quantities. The after-treatment consists of 
a stomachic, such as a combination of quassia and 
strychnin, or tincture of rhei and tincture of nux 
vomica. 

Chronic Gastritis 
This disease is often the sequel to repeated at- 
tacks of the acute form ; it may appear also as a 
secondary complication in other diseases. Gen- 
erally, however, it is the result of continued im- 
proper diet, associated with a debilitated state of 
the system. 

Symptoms. — Evidences of chronic gastritis are 
somewhat similar to those of acute gastritis, with 
the difference that the appetite is not entirely lost 
but is extremely capricious. Vomiting comes on 
only after eating, and there is no fever, and seldom 
is there evidence of pain on pressure over the epigas- 
trium. The patient gradually becomes emaciated. 

Treatment. — Constipation or diarrhea must be cor- 
rected at the outset and the diet previously indi- 
cated for acute gastritis prescribed. Internally a 
combination of two grains of pepsin, two and one- 
half grains of bismuth subnitrate, and 1-100 grain 
of strychnin may be given immediately after meals 



GASTRITIS 53 

three times daily, followed later with an alterative 
and tonic mixture such as: 

Tr. nucis vomicae drs. 4 

Liqr. acidi arsenosi drs. 1 

Tr. gentiange oz. 1 

Syr. aurantii oz. 1 

Aquofi, q. s ozs. 4 

M. Give two drams three times daily. 
Or 

n 

Ac. nitrohydrochlorici drs. 2 

Tr. gentianas comp oz. 1 

Syr. aurantii oz. 1 

Aquse, q. s ozs. 4 

M. Give one dram three times daily, after meals. 

The diet must be carefully regulated to avoid a 
recurrence of the trouble, the animal being fed 
small quantities at a time and several times daily. 
Proper exercise, grooming with a hound glove, and 
sanitary surroundings are valuable aids to treat- 
ment that are frequently overlooked. 

Foreign Bodies in the Stomach 

The variety of substances which may be swallowed 
either intentionally or accidentally while at play is 
so extensive as to prohibit a complete list; but 
sticks, stones, pins, needles, bones, coins, rubber 
balls, and corks are among those generally met with. 

Symptoms, — In many instances the patient shows 
no ill effects unless the foreign body either perfo- 
rates the stomach or, passing on, blocks the in- 
testines. Silver coins may remain in the stomach 
for years and cause no illness whatever, but copper 
coins undergo corrosion in the stomach or intes- 
tine and in time cause serious illness or death. In 
the case of pins, hat pins, and needles, their pres- 
ence in the stomach is often unsuspected until an 
abscess forms either in the esophageal region, be- 



54 CANINE MEDICINE AND SURGERY 

tween some of the posterior ribs, or in the flank. 
The history of the case should be obtained and the 
habits of the animal inquired into, to determine 
whether the patient has actually been seen to swal- 
low something, or is in the habit of picking up and 
swallowing odds and ends. The most prominent 
symptoms are attempts at vomiting, poor appetite, 
general dullness and depression, irregularity of the 
bowels, blood in the feces, general unthriftiness, and 
emaciation. 

An examination with the Roentgen rays makes 
the diagnosis more positi^^e. A careful digital ex- 
amination should also be made through the abdomi- 
nal walls, l:)Ut this is -very often negative. 

Treatment. — In the case of small articles, such as 
needles or small nails, the animal should be fed on 
soft or doughy food in order to inclose the foreign 
body during its passage along the intestine. Thick 
porridge is of good service here. An emetic of 1-20 
to 1-10 grain of apomorphin often proves efi^ectual in 
expelling blunt objects. If the emetic is unsuc- 
cessful, a dose of castor oil should be administered. 

In the case of hat pins, needles, meat skewers, 
or similar articles it is better to await developments, 
since in the course of a few days the point will ofte;i 
work out, causing an abscess. When this is lanced, 
the foreign body can be grasped and withdrawn ; if 
a hat pin, the head is cut off with wire cutters and 
allowed to fall back into the stomach ; the abscess 
cavity must be treated antiseptically. The patient 
usually makes a rapid recovery. There is some risk 
of peritonitis, due to these substances perforating 
the stomach, but it is remarkable how seldom this 
occurs. As a rule adhesion takes place between the 
stomach and the peritoneum, thus cutting off the 
peritoneal cavity from infection. Where large sub- 



INTESTINAL CATARRH 55 

stances, such as stones, rubber l)alls, or large nails, 
have been swallowed, and the diagnosis is positive, 
gastrotomy should be performed without delay. A 
description of this operation will be found on page 
207. 

Intestinal Catarrh 

Intestinal catarrh is frequently associated with 
gastric catarrh, the etiology being the same. In- 
testinal parasites also play an important part in 
causing catarrh of the intestines. It is also seen 
as a complication or accessory ailment in distemper. 

Symptoms. — There may be vomiting, but not so 
persistent or so well marked as in gastric catarrh. 
The appetite is impaired, the temperature is nearly 
always fairly high, even up to 103 or 105 degrees Fah- 
renheit. The most prominent symptom of intestinal 
catarrh is diarrhea, the severity of which may vary 
considerably ; in mild cases- the feces are pulpy in 
consistency, while in severe cases there are often 
slimy, icteric, bloodstained, and usually very fetid 
feces. Considerable pain and straining accompanies 
the act of defecation. There is usually an abnormal 
amount of fermentation, with consequent flatulence. 
In protracted cases, emaciation is well marked, and 
the animal presents a forlorn appearance, with 
tucked-up abdomen, rough, unthrifty coat, and with 
its tail and hind quarters soiled with feces. 

Treatment. — Dietetic treatment is most important, 
and in mild cases is often all that is required. A 
spare diet of finely chopped raw meat, continued 
for several days, is the best. Above all, the im- 
moderate consumption of water must be guarded 
against. If the appetite is entirely suspended, a 
bitter tonic should be given to stimulate it. At the 
outset of the disease a moderate dose of calomel 
may be given, followed by intestinal antiseptics and 



56 CANINE MEDICINE AND SURGERY 

astringents,- — salol and bismuth subnitrate, creosote, 
or the sulphocarbolates of zinc, calcium, and sodium, 
combined with bismuth salicylate. Where there is 
much pain and tenesmus, chlorodyne, laudanum, or 
Dover's powder* may be given. In cases which ex- 
hibit great weakness, alcoholic stimulants, such as 
brandy and port wine, must be given in conjunction 
with strychnin or nux vomica. The after-treatment 
consists in a generous but non-irritating diet, and 
tonics. 

Colic 

Colic is the term here used for abdominal pain, 
which is of frequent occurrence in canine patients. 
The causes are various, the most common being 
flatulence, distension of the stomach or intestine, 
parasites, foreign bodies, violent and irritant poisons, 
hernia, intussusception, and volvulus. 

Symptoms. — The attack is sudden, the animal is 
very restless, yelping and crying out, and tries to 
hide itself. The abdomen is distended, the pulse 
quickened, and the temperature raised. Vomiting 
may occur if the dog takes food between the parox- 
ysms, which sometimes he will do. Eventually, if 
no relief is afforded, excessive prostration ensues, 
followed by death. 

Treatment. — This will depend largely upon the 
cause, and may be medical or surgical, as the case 
demands. If parasites or a foreign body in the 
stomach occasion the colic, an emetic should be 
given in the attempt to remove the cause. Hot 
fomentations should be applied externally, and a 
diffusible stimulant, such as ether, ammonia, or tur- 
pentine, given by the mouth. 

To combat the pain one-fourth grain of morphin 



*The formula of Dover's powder i.s: Ipecac 10; powdered opium 
10; milk sugar 80. The dose is two to twenty grains. 



INTUSSUSCEPTION 57 

may be given hypodermically, or chlorodyne or 
laudanum may be given orally. If the tympanites 
is very severe and persistent the stomach or the 
bowel must be punctured with a trocar and cannula. 
If these measures do not give relief within three or 
four hours, an exploratory laparotomy should be 
performed without further delay ; further surgical 
procedure depends upon the condition found. Quite 
a number of cases reveal nothing, but for some 
unexplained reason the operation nearly always gives 
relief from further vomiting and pain. 

Intussusception 

The commonest varieties of this condition are the 
ileocecal and the enteric. In the former the ileum 
is invaginated into the colon ; in the latter the small 
intestine is protruded into itself. In some cases the 
invagination may be so extensive that the bowel 
protrudes through the anus. It is most commonly 
seen in puppies and young dogs, but may occur also 
in adults. 

Cause. — Intussusception is produced by a violent 
peristalsis set up by some irritant, such as intes- 
tinal worms, indigestible food, or drastic cathartics. 

Symptoms. — The patient is seen to strain con- 
tinually, as if trying to defecate, but only a little 
fluid or dark, blood-stained mucus comes away. 
Colicky pains develop later, and vomiting occurs 
after the condition has lasted for a few hours. Ex- 
cept when straining the patient is quiet, tries to 
hide away, and shuns companionship. The eyes 
are brighter than normal. Examination of the 
abdomen by manipulation between the fingers and 
thumb reveals a sausage-shaped swelling, which in 
the early stages is not sensitive to pressure. 



58 CANINE MEDICINE AND SURGERY 

Treatment. — Unless relieved, gangrene of the 
bowel, peritonitis, and death are the usual ending, 
although occasionally sloughing of the intussus- 
cepted gut, with adhesion of the serous surfaces, 
takes place, the "cast" of the bowel being passed 
per anuhi. It is, however, not justifiable to rely 
upon this remote contingency, and immediate opera- 
tion should l)e practiced. The prognosis is good if 
operation is not delayed until adhesions have formed 
or tissue changes taken place, or until the patient 
is moribund. 

Operation. — Perform laparotomy (this operation is 
fully described on p. 205) and replace, the gut into 
its natural position by manual manipulation. The 
after-treatment is to keep the patient quiet for some 
days and on a liquid diet, the bowels l)eing "rested" 
by the use of morphin. 

Diarrhea 

Diarrhea consists of the frequent passage of liquid 
feces, often ofifensive and accompanied by pain and 
straining. 

Cause. — Diarrhea may be a symptom of intes- 
tinal catarrh or of distemper, but it is more often 
caused by irritant food, chills, intestinal parasites, 
injudicious use of purgatives, or contaminated water. 

Symptoms. — The evacuations are generally pain- 
ful, frequent, and fluid, and have a fetid odor; thirst 
is increased, but the appetite is often unaffected. If 
untreated, the animal soon becomes unthrifty, emaci- 
ated, and may even die from exhaustion. 

Treatment. — If dietetic errors are suspected a full 
dose of castor oil should be administered, followed 
by chlorodyne or laudanum combined with an in- 



DIARRHEA 59 

testinal antiseptic, astringent, and sedative as in the 
following : 
R 

Bismuthi subnitratis drs. 2 

Ac. nitrici dil drs. l^/^ 

Chlorodyne drs. iy2 

Tr. catechu drs. 3 

Aquae, q. s ozs. 4 

M. Give a half-ounce in water three times daily. 
Or 
R 

Tr. kino, 
Tr. catechu, 

Tr. opii camphoratse, aa drs. 4 

Misturse cretae, q. s ozs. 4 

'M. Give one dram every three hours. 

Another prescription which gives good results in 
persistent diarrhea is as follows : 

Ac. sulphurici aromatici, 
Tr. opii, 

Spts. camphorae, aa drs. 2 

Aquae cinnamonii, q. s ozs. 4 

M. Give one dram three times daily. 

If parasites are the cause, a vermifuge must be 
administered, followed by a laxative and any of the 
above anti-diarrheal mixtures. 

Where there is much fetor, zinc sulphocarbo- 
late is particularly indicated and must be pushed 
until the dejections resume their normal color. 

The diet must be non-irritating, raw meat being 
best. Milk and lime water is admissible, but large 
quantities of water must not be allowed. 

In persistent and protracted cases stimulants may 
be needed and strychnin or nux vomica should be 
given to restore the normal tone of the bowels. 
Astringent enemas have many advocates, l)ut as 
they produce much straining and discomfort, and in 
reality reach only a very short distance up the 



60 CANINE MEDICINE AND SURGERY 

bowel, they are practically valueless, except in the 
treatment of ulcerative conditions of the rectum, 
when a five- to twenty-per-cent solution of nitrate 
of silver, or better of protargol, may be used. 

Constipation 

Constipation is the opposite condition to diarrhea, 
being a partial or complete absence of defecation. 

Cause. — Old age and debility, paralysis of the 
bowels, improper diet, mechanical obstruction either 
by foreign bodies or by masses of indigested food, 
hair, and bones are the commonest causes of con- 
stipation. Hemorrhoids and engorgement of the 
anal pouches or glands are further causes of this 
condition. Constipation may also be a symptom in 
various febrile disorders, such as distemper, icterus 
(caused by absence of bile), peritonitis, or enteritis. 

Symptoms. — The chief symptom is the more or 
less complete suppression of defecation. The patient 
makes continual efforts, but is either unsuccessful 
or passes only small, dry, single balls of excrement, 
which are often composed of undigested portions of 
food and mixed with hair or pieces of bone. Some- 
times it is blood-stained. At first the appetite is 
only slightly impaired, but later it becomes almost 
or entirely suppressed. Peristalsis is absent ; the 
abdomen may be distended with gas, but more 
often it is tucked up and hard. On palpation a 
hard, sausage-shaped mass may be felt in the abdo- 
men, sometimes extending as far forward as the 
ensiform cartilage. Manipulation is usually pain- 
ful. The temperature is raised slightly, and upon 
introducing the oiled finger into the rectum the 
accumulated fecal mass may be felt. Tiie animal 
is depressed, and may have colicky pains. There is 
a peculiar carriage of the tail characteristic of tliis 
ailment. 



CONSTIPATION 61 

Treatment. — This depends largely upon circum- 
stances. In the constipation found in the course 
of fevers the condition does not get so far as the 
formation of the "fecal tumor" above described, and 
a mild laxative is all that is required in ordinary 
cases. 

Foreign bodies may require surgical interference 
if laxatives do not bring about the desired result, 
but in no instance should drastic purgatives be given. 
In peritonitis and enteritis, if the case demands the 
correction of the constipation, enemas alone should 
be relied upon to empty the bowels. 

In old, debilitated, and improperly fed dogs, where 
the fecal tumor is well marked and there is marked 
absence of peristalsis (paralysis of the bowel), small 
repeated doses of olive oil and 1-100 to 1-60 grain 
of strychnin must be administered. Enemas of 
warm oil should be injected three or four times 
daily to soften the impacted mass, and the abdo- 
men gently massaged to stimulate peristalsis. 
Where the impacted mass can be reached, it must 
be removed piecemeal, either by the finger, a rectal 
spoon, or, best of all if available, by an instrument 
known as French's rectal curette, which is a blunt 
curette having a hollow shaft and an opening in the 
spoon portion. A rubber tube is attached to the 
shaft and a continuous flow of water, obtained from 
an elevated douche can, washes away the particles 
removed by the curette. Much patience and gentle- 
ness of manipulation is required to avoid injury to 
the walls of the rectum, but the operation must be 
repeated and persisted in until all the impacted 
mass is removed. After recovery the dog should 
be fed on lean meat, free from bones, milk, and beef 
tea. Regular exercise should be insisted upon, and 
the animal given a good nerve tonic. In cases that 
do not yield to the above treatment laparotomy 



62 CANINE MEDICINE AND SURGERY 

may be performed under rigid antiseptic precau- 
tions, and if the condition of the impacted bowel 
allows, the mass must be gently broken up and 
pressed toward the rectum. If, however, the bowel 
is inflamed or necrotic, resection of the affected 
portion must be performed and the ends joined by 
either of the methods given in the description 
of that operation, which is discussed in Part II, Sec- 
tion IV (see p. 209). The prognosis, of course, is 
graver where resection has to be resorted to; still, 
recoveries do take place, and the operation should 
be tried in the effort to save the animal's life. 

Typhlitis 

Typhlitis, or inflammation of the cecum, is of 
more frequent occurrence than is usually supposed. 
It is caused by constipation, indigestible foods, or 
by microorganisms. The symptoms are acute and 
persistent abdominal pain, especially after a meal. 
There is pain on pressure over the posterior portion 
of the abdomen, and usually the swollen cecum can 
be felt through the abdominal walls. 

Treatment. — All food must be withheld, and only 
water, or milk and lime water, allowed. A mild 
laxative to empty the bowels, assisted by rectal in- 
jection of oil or warm soapy water, should be ad- 
ministered. One-fourth grain of morphin, hypoder- 
mically injected to relieve pain, and hot applications 
to the abdominal region should be followed by 
gentle massage over the cecum. Should the above 
treatment, fail to give relief in twelve hours 
laparotomy must be performed, with the usual pre- 
cautions, and the cecum emptied by gentle massage. 
The after-treatment consists of rectal feeding for 
three or four days, when the patient may be allowed 
liquid food in small quantities until the abdominal 
wound is healed. The diet should be of an easily 



ENTERITIS 63 

digestible and non-irritating nature for a fortnight 
longer, and bones should not be allowed for at least 
six weeks. 

Enteritis 

Enteritis, or inflammation of the bowels, is an ex- 
ceedingly fatal disease, and if at all extensive, re- 
covery is doubtful. 

Cause. — Among the many causes leading to this 
grave condition are poisons — either chemical or 
bacterial — foreign bodies, intussusception, and intes- 
tinal parasites — consequently both symptoms and 
treatment will vary somewhat in accordance with the 
causative factor. 

Symptoms. — In enteritis produced by poisons the 
onset of the attack is sudden, the pain continuous 
and severe, and the abdomen is exceedingly tender 
on pressure and in many cases tympanitic. Peri- 
stalsis may be completely in abeyance or there may 
be profuse and bloody diarrhea. Upon examination 
the lips, tongue, and mucous membrane of the 
mouth and jaws are found to be intensely inflamed, 
sometimes eroded and hanging in shreds. The ani- 
mal evinces great depression and a disposition to 
hide away in dark corners and secluded places. 
Convulsions may supervene, in one of which the 
animal may die, or it may gradually lapse into coma 
and die unconscious. 

The treatment in these cases consists in emptying 
the stomach either by the stomach pump or by an 
emetic (1-20 to 1-10 grain of apomorphin), and in 
administering the suitable antidote to the poison. 
This having been done, the inflamed surfaces of the 
stomach and bowels must be soothed with demul- 
cents, such as barley water, linseed tea, or marsh - 
mallow tea, and protectives given, such as full doses 
of bismuth subnitrate. To relieve the agonizing 



64 CANINE MEDICINE AND SURGERY 

pain hypodermics of one-fourth to one grain of 
morphin sulphate, or the H-M-C tablets (No. 1) 
may be given as required. 

Hot applications to the abdomen afford relief and 
if necessary the patient's strength should be sup- 
ported with stimulants, such as ether or brandy ad- 
ministered hypodermically. In cases that respond 
to treatment and become convalescent the diet 
should be restricted at first to milk, gruel, and beef 
tea. Later on, very small quantities of soft and 
non-irritating food may be given. 

When enteritis is due to any of the causes above 
mentioned other than poisons, the attack usually 
comes on more slowly and as a sequel to other pre- 
liminary disorders. The animal becomes more de- 
pressed, the nose is hot and dry, the temperature 
extremely high, 105 to 107 degrees Fahrenheit, and 
the pain continuous. The abdomen is tender, fre- 
quently tympanitic, and sometimes hard and tense. 
Peristalsis is absent, and constipation obstinate. The 
animal evinces intense thirst, but the stomach is so 
irritable that vomiting is easily excited, even by 
water. Symptoms of collapse appear, the pain 
abates, the pulse is barely perceptible, the mouth 
feels cold and clammy, and the patient dies in coma 
or, more rarely, in convulsions. In all forms of 
enteritis extreme fear and apprehension are evident, 
the patient presenting a haggard, miserable, and ap- 
pealing appearance. 

Treatment. — Enteritis following intussusception, 
impacted foreign bodies, and so on, is almost invari- 
ably fatal ; operation offers the only hope for re- 
covery, and that is most forlorn. In other cases, 
however, anodynes and hot applications to the ab- 
domen to relieve pain, with demulcents to protect 
and sooth the inflamed surface, enemas to gently 
solicit action of the bowels, and stimulants as re- 



TUMORS 65 

quired, constitute the line of treatment to be fol- 
lowed. The after-treatment as regards diet is as be- 
fore mentioned. 

Tumors 

Neoplasms of the intestines arc fortunately of 
rare occurrence in dogs, as the diagnosis is almost 
impossible, but their presence may be suspected in 
cases where the digestive functions are disturbed 
and continual attacks of pain, especially after meals, 
and rapid emaciation ensue. Their presence may 
sometimes be diagnosed either by palpation through 
the abdominal walls in thin subjects or by the aid 
of the Roentgen rays. The varieties found are sar- 
comas and carcinomas. 



SECTION VII 

DISEASES OF THE RECTUM AND ANUS 

THIS class of ailments includes hemorrhoids, 
prolapsus recti, prolapsus ani, fistula in ani, 
atresia ani, and obstruction of the anal glands. 

Hemorrhoids 

A dilated and varicose condition of the veins 
around and just within the anus is known as hemor- 
rhoids. This troublesome condition is frequently 
seen in old, overfed, and fat dogs. 

Cause. — Constipation, overfeeding, debility, im- 
paired portal circulation, old age, and want of exer- 
cise are the major causes of hemorrhoids in dogs. 

Symptoms. — Pain and irritation during defecation 
and pruritus, the animal continually licking the 
parts and rubbing them on the ground, are evi- 
dences of hemorrhoids. The anal surface appears 
moist and swollen and the feces are frequently 
streaked with blood. Constipation is often present 
both as a symptom and as a cause, the patient, 
owing to the pain experienced, delaying the defeca- 
tion as long as possible. 

Treatment. — This consists in attention to the state 
of the bowels, mild laxatives such as cascara, 
phenolphthalein, or olive oil being given to effect, 
and local treatment to the afifected parts. The anal 
region should be kept clean and dressed with 
anodynes and astringents, such as adrenalin oint- 
ment, hazelin ointment, bensinol ointment or the 
Unguentum Gallae et Opii (B. P.). In internal 
piles suppositories of any of the above may be 

66 



PROLAPSUS RECTI 67 

used so as to bring the medicaments into direct con- 
tact with the dilated veins. In cases where the 
above treatment is ineffectual a resort must be had 
to surgical interference. The piles may be removed 
either by ligation or by clamps and the actual cau- 
tery. By the former method, the piles are picked 
up separately with forceps and ligated by passing 
around them a curved needle armed with the liga- 
ture, after first cutting a groove around the base of 
each with blunt-pointed scissors. A\niere the clamp 
is used the pile is picked up as before, the clamp 
applied, and the loop removed with the cautery. In 
operating by either method a general anesthetic is 
advisable. 

After-treatment. — After the operation the patient 
should be kept without food for twenty-four hours 
and for the next week allowed only small quantities 
of milk, beef tea, or other sloppy diet. Small doses 
of opium should be given three times a day to keep 
the bowels at rest, but if no movement of the 
bowels has taken place by the fourth day a warm 
enema of oil should be given. Locally, the parts 
must be kept clean and dressed with antiseptics, 
such as chinosol ointment or suppositories. 

Prolapsus Recti 

This condition generally occurs suddenly during 
the course of or after recovery from some debilitat- 
ing illness. 

Cause. — Debility, constipation, diarrhea, hemor- 
rhoids, rectal irritation and the consequent straining 
are all important causes of prolapsus recti. 

Symptoms. — The patient shows a disposition to 
hide, and is quieter than usual. The floor on which 
it has lain down is blood-stained, as are also the 
hind quarters. Examination, which is resented, re- 
veals the prolapsed gut, congested and, it may be. 



68 CANINE MEDICINE AND SURGERY 

lacerated. If not treated, the gut in a few hours 
becomes intensely swollen, of a dusky hue, and ex- 
ceedingly painful, and if further neglected death 
may take place from sliuck, collapse, or septic ab- 
sorption. When the act of defecation takes place 
the gut is seen to protrude and retract as straining 
takes place and ceases. 

Treatment. — As a rule a general anesthetic should 
be given, since the parts are very sensitive and 
there is always straining by the patient ; further- 
more, reposition is a great deal easier when the 
parts are relaxed and the patient's opposition under 
control. In recent cases before the mucous mem- 
brane of the gut has become friable and easily lacer- 
ated, the parts should be bathed freely with hot 
water, to which may be added some antiseptic such 
as creolin or chinosol, or if exceedingly congested, 
they may be sprayed with a solution of adrenalin 
chlorid, i to 10,000 or 1 to 20,000. The ^ut is then 
cautiously manipulated with the fingers and the 
prolapsed portion replaced, the rectum being 
smoothed out into its normal position with the mid- 
dle finger. A stitch or two should then be placed 
across the anus to retain the bowel, or a purse- 
string suture inserted for the same object. 

In longer standing cases in which the prolapsed 
portion is lacerated and the mucous membrane 
friable, cold water should be substituted for hot in 
the preliminary bathing as it will tone up the parts 
and render them less liable to injury during the sub- 
sequent manipulations. Straining must be con- 
trolled by morphin or cannabis indica, and the diet 
restricted to slops. Constipation should be guarded 
against by the use of laxatives of olive oil or cas- 
cara. Prolapse of the rectum is very prone to re- 
currence, and amputation will very likely be neces- 
sary to obtain permanent relief. Amputation should 



PROLAPSUS RECTI 69 

be proceeded with in the first instance if the parts 
arc badly torn or show symptoms of gangrene. 

Amputation of the Prolapsed Rectum 

Instruments. — Scalpel, scissors, tissue forceps, 
eight needles and sutures, a needle holder and ar- 
tery forceps are the instruments needed for this 
operation. An antiseptic solution (chinosol 1-1000) 
must also be provided. 

Operation. — The instruments, needles, sutures, 
and the operator's hands, having been made surgi- 
cally clean and the patient under a general 
anesthetic, H-M-C and choloform by preference, 
gentle pressure is made of the prolapsed gut 
and a needle armed with a suture (catgut 
or absorbent silk) is thrust through the gut 
from above downwards as close as possible to the 
anus ; another suture is placed transversely so as to 
cross the first at right angles. The assistant then 
holds the ends of the sutures while the operator 
amputates the gut close behind the sutures. Any 
hemorrhage is then controlled with the artery for- 
ceps and the sutures cut at the point of intersection 
and tied. In this way it is seen that the remain- 
ing portion of the rectum is secured with four 
sutures. Sutures an eighth of an inch apart are 
then put in all round the gut, the ends cut short, 
and the parts gently pushed back inside the sphinc- 
ter ani after being washed in the antiseptic solution. 

After-treatment. — All food must be withheld for 
twenty-four hours and the diet restricted to slops 
for at least four days, the bowels up to that time 
being kept quiet by small doses of opium. After 
the fourth day, if the patient is uncomfortable, a 
laxative may be given to produce action of the 
bowels, and for a month at least the feces must be 



70 CANINE MEDICINE AND SURGERY 

kept soft by the administration of laxatives (olive 
oil) and soft foods. 

Prolapsus Ani 

The causes of this condition are the same as 
those producing prolapsus recti, and while not of so 
serious a nature as that condition, it is often ex- 
ceedingly troublesome to deal with and causes the 
animal much discomfort, to say nothing of the 
unsightly appearance it presents. The symptoms are 
practically the same as in prolapsed rectum except 
that only a very small portion of the posterior part 
of the rectum appears as rather a red, angry-looking 
mass at the anal opening. 

Treatment. — Reposition is comparatively easy, 
but to induce the parts to remain in their natural 
position is often quite another matter. Astringent 
washes may be tried and the anus sutured, the same 
rules as to diet and regulation of the bowels being 
applied as in prolapsus recti. 

If these measures fail to give permanent relief, 
operation should be resorted to. The animal should 
be placed on a milk or beef-tea diet for a few days 
previous to operation and should receive a laxative 
to clean out the bowels. Immediately before opera- 
tion the patient should receive an enema, of warm 
boracic acid solution, and" a general anesthetic ad- 
ministered. The relaxed portion of the mucous 
membrane is then gently pulled out from the anus 
by the fingers and three or four elliptical wounds, 
from one-half to one inch in length, made with 
sharp scissors in the longitudinal axis of the 
mucous membrane close to the anus. The rationale 
for this operation lies in the fact that contraction 
takes place during cicatrization and thus tends to 
prevent the parts from again prolapsing. 

The after-treatment consists in giving antiseptic 



FISTULA IN ANO 71 

injections or suppositories, keeping the bowels at 
rest by means of opium, and prescribing a sloppy 
diet for a week or two. The animal should then 
be placed on a substantial, nutritious diet and every 
efifort made to improve the general condition by 
proper exercise and a good course of tonic medicine. 

Fistula in Ano 

This is a fistulous opening in the anal region. 

Causes. — Laceration of the rectum by foreign 
bodies, such as needles, fish bones, or spicules of 
bone, with subsequent abscess formation, neglected 
hemorrhoids, and constipation are common causes 
of this ailment. 

Symptoms, — The patient is continually licking the 
anal region and demonstrating the irritation that 
exists there by rubbing it along the ground. Upon 
examination a fistula, discharging pus, is seen near 
the anus. 

Treatment. — The extent and depth of the sinus 
must be accurately determined by aid of a probe 
gently and cautiously introduced. By means of a 
grooved director and bistoury the sinus should then 
be laid open, cutting through all tissues, even the 
sphincter ani if necessary, in order to provide thor- 
ough drainage. The abscesses must be evacuated, 
the fistulous walls cure'tted, and the wound tam- 
ponaded with iodized gauze, which should be re- 
moved within twenty-four hours. The wound is 
then irrigated with antiseptic lotions until healed. 

A new line of treatment for fistulse and similar 
conditions has lately come into vogue with remark- 
ably good results. The fistulous tracts are first 
syringed out with hydrogen peroxid and as much 
pus as possible removed ; a mixture of bismuth sub- 
nitrate and paraffin is then injected, so as to com- 



72 CANINE MEDICINE AND SURGERY 

pletely fill the whole tract, and the opening plugged 
to prevent the escape of the mixture. 

The formula for this bismuth-paraffin paste is as 
follows : 

Bismuth subnitrate 120 grams 

White wax 20 grams 

Paraffin 20 grams 

White vaselin 240 grams 

The mixture is heated to liquefaction before 
being used and is injected by a metal syringe that 
has been previously warmed. The treatment may 
be repeated every five days as long as necessary. 

Atresia Ani 

Imperforate anus is a congenital defect and often 
escapes notice for some hours after the puppies are 
born. Upon examination the anal opening is found 
to be absent, but the position of the anus may be 
found by a bulging of the perineum caused by the im- 
prisoned feces. In some cases the opening is merely 
occluded by the skin and all that is required to 
rectify the condition is the excision of an elliptical 
portion of the integument. In others, however, the 
rectum ends as a blind tube and is not attached to 
the anus proper. When such is the case, after re- 
moving an elliptical portion of the skin the end of 
the rectum must be sought for, brought back into 
the wound, opened, and stitched to the raw margin 
of the wound. Occasionally the rectum is entirely 
absent, and of course treatment is then hopeless. 

The after-treatment consists in the application of 
antiseptics and keeping the parts clean. 

Obstruction of the Anal Glands 

Situated on either side of the anus, the ducts 
communicating with the rectum just anterior to the 



ATRESIA ANI 73 

sphincter ani are two pouches whose walls secrete 
a mucoid substance, the function of which is to 
lubricate the parts during the act of defecation. If 
by reason of any rectal irritation the ducts of these 
glandb become blocked the secretion eventually 
causes them to become enlarged and encroach on 
the lumen of the rectum, causing difficulty and pain 
during the act of defecation. 

Symptoms. — A swelling about the size of a wal- 
nut on either side of the anus, constipation, often 
the result of the pain which defecating causes, and 
irritation shown by the animal's licking the anal 
region and rubbing it along the floor are indications 
of this ailment. 

Treatment. — In many cases the evacuation of the 
contents of the glands by pressure exerted by the 
finger introduced into the rectum and the correction 
of constipation and any dietary errors are sufficient 
to bring relief, but if the condition continues, more 
radical measures must be adopted. The glands 
should be opened freely from the exterior, the con- 
tents cleaned out, and the walls freely curetted and 
then painted with tincture of iodin to destroy their 
secreting properties. The wounds are then treated 
antiseptically until healed. The operation is quite 
safe, and if care is taken to entirely destroy the 
secreting walls a permanent cure may be confi- 
dently expected. 



SECTION VIII 

DISEASES OF THE LIVER 
Icterus or Jaundice 

ICTERUS cannot properly be called a disease per 
se, but is really only a symptom of some other 
disease affecting the liver or its ducts. Since diverse 
causes may produce icterus, it is necessary for pur- 
poses of clinical description to classify the various 
forms of icterus according lo their etiological 
factors. 

Catarrhal Jaundice 

Catarrhal jaundice occurs usually in connection 
with gastroduodenal catarrh, the catarrhal condition 
extending up the ductus choledochus, the duct be- 
coming blocked by the subsequent swelling and 
formation of mucus. The bile is thus prevented from 
reaching the bowel and dams back to the liver, 
where it is reabsorbed into the circulation. 

Symptoms. — In addition to the symptoms appear- 
ing in the course of an attack of gastroduodenal 
catarrh, the visilile mucous membranes are found to 
be stained a characteristic yellow color. Later on 
bile may be found in the saliva, urine, and milk 
of nursing bitches. Lastly the skin becomes deeply 
stained, and if the stenosis of the duct is complete 
cholemia supervenes with a fatal termination. Its 
advent is recognized by great weakness, fall of tem- 
perature, slow, weak pulse, and increase of icteric 
symptoms. The patient dies in coma. In addition 
to the foregoing signs, the absence of the bile in the 
intestinal tract seriously interferes with the diges- 
tive processes, peristalsis is diminished, and the 

74 



ICTERUS 75 

feces become clay colored and very offensive. Con- 
stipation is usual. Catarrhal jaundice is the most 
important jaundice of the dog, and the prognosis is 
usually grave. 

Heptogenous Icterus 

This form of icterus is seen as a symptom in 
hepatitis, atrophy of the liver, degenerations of the 
liver, neoplasms, and thrombosis of the portal vein. 

Hematogenous Icterus 

Hematogenous icterus is jaundice occurring in 
the course of septic or infective diseases. It is due 
to decomposition of the blood. 

Malignant Malarial Jaundice 

This, form of jaundice is a symptom of canine 
malaria (caused by the Piroplasma canis). 

Treatment. — One of the most essential factors 
in the treatment of catarrhal jaundice is the proper 
regulation of the diet. Lightly cooked or raw meat, 
finely minced and mixed with small c|uantities of 
boiled rice or oatmeal, form the best ration. Con- 
stipation should be overcome by moderate doses 
of calomel followed in a few hours by a saline laxa- 
tive such as Epsom salt or artificial Carlsbad salt. 

The abdomen over the region of the liver should 
be gently massaged, as the gentle pressure helps 
to mechanically empty the gall bladder. Boldin, 
the active principle of Peumus boldus, gr. 1-30, 
bilein gr. 1-8 combined with hyoscyamine gr. 1-250, 
should be given three times daily. In cases with 
great depression and threatening coma, recourse 
must be made to stimulants such as strychnin, 
caffein, camphor, and so on. 

In the heptogenous form the icteric symptoms are 
best treated with small repeated doses of calomel. 



76 CANINE MEDICINE AND SURGERY 

followed by nitromuriatic acid. Other treatment 
must be directed against the primary condition. 

Hematogenous icterus must be treated by vigor- 
ous eliminative measures combined with proper 
treatment of the condition responsible for it. 

Hepatitis 
(Inflammation of the Liver) 

Hepatitis occurs in two forms, acute parenchy- 
matous and chronic interstitial. 

Cause. — Acute parenchymatous hepatitis, inflam- 
mation of the liver substance, occurs during the 
course of the various infectious diseases. Injudicious 
feeding on rich, stimulating food, exposure to cold, 
and phosphorous poisoning are also causes of hepa- 
titis. 

Symptoms. — Vomiting, colicky pains, pain on 
pressure over the hepatic area, icterus and fever are 
evidences of hepatitis. 

Treatment. — Administer small doses of calomel 
followed by saline laxatives, hot applications to the 
abdomen and hypodermic injections of morphin as 
required to relieve pain. The diet should consist 
of sloppy food during the attack, and previous 
errors corrected thereafter. 

Cirrhosis of the Liver — Interstitial Hepatitis 

The most marked result of chronic interstitial 
hepatitis is the formation of new connective tissue 
in the liver. The character, amount, and distribu- 
tion of the new tissue varies greatly in different 
cases. Secondarily there are usually marked changes 
in the liver cells, blood vessels, and gall ducts. The 
new tissue is most commonly formed and most 
abundant in the periphery of the lobules along the 
so-called capsule of Glisson, but it may extend into 



HEPATITIS 77 

the lobules between the liver cells. The new formed 
tissue tends to contract, causing atrophy of the cells 
from pressure or from interference with the portal 
circulation. The bile ducts may also become obliter- 
ated and both the secretion and the outpouring of 
the bile be interfered with. Owing to the above men- 
tioned changes, secondary lesions occur ; these are 
ascites or dropsy icterus, gastrointestinal catarrh, 
and hemorrhages. 

Cause. — The causes of cirrhosis in the dog are 
unknown, but it is often seen in connection with 
cardiac diseases. 

Symptoms. — In cirrhosis of the liver gastroin- 
testinal catarrh with icterus, abdominal dropsy, car- 
diac disturbances, and gradual emaciation give evi- 
dence of the disease. 

Treatment. — Cirrhosis of the liver invariably 
sooner or later ends in death, and treatment is in- 
effectual. However, life may be prolonged by treat- 
ing the symptoms as they arise, and by liberal diet, 
alteratives and tonics keeping up the patient's 
strength. 

Ascites — Abdominal Dropsy 

The accumulation of fluid in the abdominal cavity 
is always a secondary condition. The fluid in true 
ascites is a non-inflammatory transudate of serum 
from the peritoneal blood vessels and must be dis- 
tinguished from the inflammatory exudate formed in 
peritonitis. The fluid is generally straw colored, 
though sometimes it has a reddish tinge ; it is sticky 
to touch and clots readily on exposure to the air. 
It is usually clear, but may contain shreds of 
fibrin. Contrary to the exudate of peritonitis, it is 
rich in fibrinogen but poor in cells. 

Cause. — Cirrhosis of the liver, on account of 
the obstruction of the portal circulation, for the 



78 CANINE MEDICINE AND SURGERY 

same reason new growths of the liver or the peri- 
toneum are etiological factors ; as are also renal dis- 
ease and cardiac disease. 

Occasionally ascites appears after an attack of 
distemper, there being no organic changes discern- 
ible. Such cases yield readily to treatment and 
make permanent recoveries. Recovery in cases due 
to primary cardiac, renal, or hepatic disease will de- 
pend upon the extent and amenability to treatment 
of the primary cause. 

Symptoms. — This disease is manifested by u 
gradual enlargement of the abdomen, pendent belly, 
and a characteristic falling in of the flanks. Palpa- 
tion with the finger tips and auscultation reveal 
the presence of fluid within the cavity. In great 
accumulations of fluid the pressure upon the dia- 
phragm and lungs causes much difficulty in respira- 
tion, sometimes even to sufl^ocation. The appetite 
is variable, the secretion of urine diminished, and 
constipation usually present. The conditions which 
may simulate ascites and which may be mistaken 
for that condition are : 

1. Chronic Peritonitis. — The history of the case, 
the absence of cardiac, renal, or hepatic disease, and 
the character of the fluid, determined by examina- 
tion of a sample obtained l)y aspiration with a fine 
needle or trocar, will, however, serve to make the 
distinction. 

2. Pregnancij. — Palpation of the abdominal walls 
and contents reveals the true nature of the en- 
larged abdomen. 

3. Distended Bladder. — -The shape of the abdo- 
men is different, and dyspnea is not increased by 
elevation of the hind quarters as it is in abdominal 
dropsy. 

4. Urine in Hie Ahdonnnat Cavifij From h'li/i- 



ASCITES 79 

lured liludder. — Urine in the abdominal cavity from 
ruptured bladder is a condition in which there are 
always symptoms of collapse, absent in ascites. As- 
piration reveals urine instead of ascitic fluid. 

Treatment. — Alleviation and sometimes permanent 
relief may be obtained for this condition by (1) 
purgatives; (2) diuretics; or (3) paracentesis ab- 
dominis. In addition treatment against the'primary 
cause must, however, be instituted, and even then in 
many cases recurrences occur. It is usual, however, 
in addition to treating the primary cause to make 
use of all three of the above-named methods of 
treatment for relieving the ascitic symptoms. 

1. Drastic purgatives are here indicat:ed : Elaterin 
m doses of 1-20 to 1-12 grain or one to three grains 
of colocynth are the most useful. These cathartics 
cause copious fluid evacuations. 

2. Digitalis, potassium iodid, potassium asetate, or 
spirits of juniper are the usual diuretics employed. 

The following is a useful formula for a diuretic 
pill: 

Scillae, 
Digitalis foliae, 

Ext. hyoscyami, aa gr. 1 

Calomel gr. 1-4 

Misce et fiat pilula mitte No. XII 
Sig.— Give one pill three times a day to free elimination. 

3. The evacuation of the fluid by means of the 
trocar and cannula — paracentesis abdominis. (The 
technic for this operation will l)e found on p. 204.) 
This operation should not be delayed if there is 
excessive dyspnea, and it may repeated as often as 
required. The diet should consist of meat extracts, 
milk, and finely minced meat. W'ater should be 
allowed only in small quantities. The patient should 



80 CANINE MEDICINE AND SURGERY 

afterwards receive a good course of tonic treat- 
ment. 

Diabetes Mellitus 

This is a condition in which the urinary secretion 
is not only abnormally increased but also contains 
a large quantity of sugar. 

Cause. — This disease is essentially one of per- 
verted hepatic metabolism, where glycogenic func- 
tion IS interfered with by the absence or poverty of 
the internal secretion of the pancreas. Due either 
to disease of or to a lack of function of the islands of 
Langerhans in the pancreas, this internal secretion 
is diminished or suppressed and its absence from the 
blood stream causes the perverted metabolism in the 
liver. Sugar in the urine is also found, after re- 
moval of the pancreas, in concussion of the brain, 
fracture of the skull, epilepsy, urari poisoning, and 
after large doses of morphin and amyl nitrate. 

Symptoms. — Diabetes mellitus is evidenced by 
depression, dullness, and great emaciation, although 
the appetite is enormously increased. Thirst is in- 
creased and the patient passes large quantities of 
urine of high specific gravity, 1,035 to 1,060, con- 
taining from seven to twelve per cent of sugar. 

Ulceration of the cornea and blindness may occur 
from cataract formation, and a chronic bronchitis is 
also often associated with this condition. Diarrhea 
is usually persistent. The course of the disease is 
gradual, the animal slowly wasting away, finally 
lapsing into coma in which it dies. Sometimes to- 
ward the end the comatose state is ushered in by 
convulsions. The prognosis is unfavorable. 

Treatment. — The diseased animal should be given 
a meat diet with as little carbohydrates as possible 
in cases of diabetes mellitus. Th'e administration of 
arsenic in the form of Fowler's solution is the most 



DIABETES MELLITUS 81 

effectual form of medication in checking the forma- 
tion of sugar in the liver. Glycerin also has the 
same property of regulating the glycogenic function 
of the liver and may be given in conjunction w^ith the 
arsenics. 

In impending coma, large doses of sodium bicar- 
bonate must be given, and if coma has supervened 
50 to 100 cubic centimeters of a saturated solution 
of the same salt should be given intravenously. 

The treatment that has up to the present time 
given the most favorable results is the administra- 
tion of an extract of pancreas containing all the 
ferments combined with arsenic and bromid of gold. 
This extract, obtainable under the name of trypso- 
gen jambul (Eugenia jambolana), also has the prop- 
erty of arresting the formation of sugar, and may be 
given in doses of from five to ten minims of the 
fluid extract or five to ten grains of the powdered 
seed. It may also be given with good effect com- 
bined as follows in tablet form : 

Antipyrin grs. ii 

Fluid extract jambul m. ii 

Codein sulphate gr. ss 

Give one such tablet, two or three times a day 
or oftener, to maintain effect. 



SECTION IX 

DISEASES OF THE KIDNEY 

DISEASES of the kidney in the dog are of rela- 
tive unimportance owing to their rarity. For 
clinical purposes they may be classed as follows : 
acute nephritis, chronic nephritis, suppurative ne- 
phritis, pyelitis, degenerations, neoplasms, and para- 
sites. 

Acute Nephritis 

(Acute Inflammation of the Kidney) 

Cause. — Acute nephritis occurs from various 
causes. It may arise from blows and injuries to the 
back or from exposure to cold. Or it may occur 
during the course of infectious diseases, such as dis- 
temper, bronchitis, septicemia, and pyemia, which 
fact is not remarkable when we remember that 
many bacteria and their toxins are excreted by the 
kidneys. Nephritis also follows poisoning by 
arsenic, mercury, phosphorus, lead, male fern, squill, 
turpentine, croton oil, cantharides, tar, phenic acid, 
ergot, and other poisons. It may also arise from 
infection extending from the pelvis of the kidney 
(pyelitis), the ureters, or bladder (cystitis). 

Symptoms. — The most important and in the 
course of severe infectious diseases sometimes the 
only symptoms are in connection with the urine. 
There is well marked albuminuria, the quantity of 
urine (except in the initial stage, when for a few 
hours it may be increased) is much reduced, some- 
times entirely suppressed for several days. The 
causes of this anuria are stoppage of the urinary 
canals by casts, inflammatory swelling of the kidney 

82 



NEPHRITIS 83 

tissues and consequent compression of the ducts, 
and diminished secretion of water. 

The specific gravity of the urine during acute 
nephritis is higher than normal (1,035 to 1,050), and 
the urine itself is thicker in consistency, slimy, tur- 
bid, dark in color, and may be blood-stained (hema- 
turia). A microscopic examination reveals the vari- 
ous kinds of casts in large quantities, numerous 
epithelial cells, and red and white blood corpuscles. 

The discharge of urine occurs only in small quan- 
tities during acute nephritis and is accomplished 
by considerable pain and straining. If the bladder 
is examined per rectum it is found to be empty. 
Pressure over the loin causes pain, direct manipula- 
tion of the kidneys themselves is painful, and they 
are found to be enlarged. 

Renal colic is most marked at the commencement 
of the disease. The patient arches his back, and the 
gait is staggering. In male animals one testicle is 
often drawn up. The appetite is suspended from 
the beginning and vomiting is common. Constipa- 
tion generally sets in soon after the v^omiting ap- 
pears, to be later alternated with diarrhea. 

The temperature ranges from 103 to 105 degrees 
Fahrenheit. At first the pulse is hard and strong, 
but later on becomes weak and fast. Hydremic 
swellings appear on the head, breast, belly, scrotum, 
extremities and within the abdomen, while abdom- 
inal dropsy is also sometimes seen. 

In the severer cases, tending to a fatal issue, the 
symptoms of uremia are added to the foregoing. 
Uremia consists of an accumulation of urinary con- 
stituents in the blood and tissues. The symptoms 
of this condition are a fall of temperature, vomiting, 
great weakness, dyspnea, convulsions, and coma. 
The patient exhales a characteristic uriniferous odor 
from the lungs and skin. 



84 CANINE MEDICINE AND SURGERY 

Treatment. — The treatment of acute nephritis 
must begin with the prohibition of all foods and 
drugs having an irritant effect upon the kidneys, 
and the diet must consist exclusively of milk. The 
bowels must be kept freely active with cathartics — 
one to two grains of calomel — and the kidneys 
solicited by non-stimulating diurectic such as five 
to twenty grains of potassium acetate. If edema is 
present the potassium acetate may be replaced ad- 
vantageously by digitalis. 

To relieve the congestion warm, moist compresses 
may be applied to the loins and hypodermic injec- 
tions of morphin sulphate given. In urgent cases 
the patient should at once be placed in a hot bath, 
rubbed dry, and kept warm with flannel coverings. 
Later on from five to twenty minims of tincture of 
iron perchlorid with a bitter tonic, such as one 
half to one ounce tincture of cinchona, may be 
given with advantage. 

Chronic Nephritis 

Chronic inflammation of the kidneys may develop 
from the acute form or it may assume an insidious 
chronic form from the beginning. 

Cause. — Irritants to the kidney substance such 
as chemical irritants, bacteria, emboli, and the ex- 
tension of infection from the pelvis in cases of 
pyelitis, may cause chronic nephritis where the irri- 
tation is not severe enough to produce acute ne- 
phritis. 

Symptoms. — These symptoms come on so grad- 
ually that the disease may be far advanced before 
it is noticed. The patient exhibits an unexplained 
lassitude and loss of appetite, and later dropsical 
swellings appear on the dependent parts and direct 
one's attention to the urine, which alone can give 
diagnostic data. 



NEPHRITIS 85 

Upon examination we find that the urine has its 
specific gravity increased, and contains albumin, 
epithelial cells, casts, fatty granular cells, and some- 
times red blood corpuscles also. The amount se- 
creted is always diminished, although in the dog it 
is not always easy to get reliable information on 
this matter. 

Upon further examination the pulse is found to 
be Jiard and tense and the heartbeats strong and 
audible on both sides of the chest. The area of 
cardiac dullness on percussion is found to be in- 
creased. All these symptoms point to hypertrophy 
of the heart, a common sequel to renal disease. The 
temperature is usually only slightly above normal ; 
thirst is greatly increased. The disease may go 
on to a fairly favorable termination, its intensity 
may increase, uremia and death supervening, or 
again it may pass into the chronic indurative stage. 

When chronic induration of the kidney takes 
place, the urine becomes plentiful, is of a low 
specific gravity, contains few casts or epithelia, 
and but little albumin. The dropsical swellings dis- 
appear; thirst is very intense and the blood pressure 
is high. (Compensatory hypertrophy of the heart.) 
If this compensation is complete the patient may 
survive for years, but gradually the strain on the 
heart leads to increasing incapacity of that organ. 
The pulse grows irregular and feeble, and catarrh of 
the bronchi, stomach, and intestines sets in, com- 
bined with dyspnea. Anemia is a constant symp- 
tom. The secretion of urine again diminishes, while 
the specific gravity and the albuminous content in- 
crease. Death finally ensues from uremia. 

Treatment. — The treatment of chronic nephritis 
is much the same as for the acute form, though the 
prognosis is more unfavorable. Cardiac tonics such 
as digitalis or cafifein must first of all be adminis- 



86 CANINE MEDICINE AND SURGERY 

tered and the bowels kept open with calomel. Po- 
tassium iodid should be given for its diuretic and 
deobstruent properties and the anemia combated 
with one half dram of tincture of iron perchlorid. 
The uremic symptoms must be met by drastic pur- 
gatives and stimulants. Elaterium is the drug of 
choice for this condition and should be given in 
doses of one-fourth of a grain. 

Suppurative Nephritis 

This grave condition arises from the invasion of 
the kidney by pyogenic organisms during the course 
of some other diseases, such as septicemia, pyemia, 
endocarditis, pneumonia through metastasis, or dur- 
ing purulent cystitis by way of the ureters or from 
renal calculus. The condition occurs in two forms, 
the diffuse and localized (abscess of the kidney). 
In the latter form the whole kidney may become 
changed, by the complete destruction of its pa- 
renchyma, so that its capsule becomes a sac con- 
taining nothing but pus. 

Symptoms. — These are usually masked by the 
symptoms of the primary disease, but emaciation, 
increased thirst, fluctuating temperature, and an- 
orexia point to suppuration and the urine should be 
examined. The urine is usually offensive, contains 
blood and kidney detritus, and is thick and slimy. In 
thin animals the kidney may be palpated from the 
exterior ; and in small animals it may be palpated 
per rectum and the condition recognized. 

Treatment. — The treatment of this condition is 
purely surgical and consists of aspirating the pus 
by puncture in the lumbar region or the extirpation 
of the affected kidney by laparotomy. This opera- 
tion is fully described on page 205. 



RENAL J^EOPLASMS 87 

Pyelitis 
(Inflammation of the Pelvis of the Kidney) 

Cause. — Pyelitis is the usual result of an in- 
fection spreading^ from the bladder to the kidney. 
It also often develops in the course of infectious 
diseases, and may be caused by irritant poisons and 
renal calculi. The presence of the Strongylus gigas 
in the pelvis of. the kidney may lead to pyelitis. 
This, however, is of rare occurrence. 

Symptoms. — The manifestations of pyelitis are so 
indefinite that we have to rely for its diagnosis 
almost entirely upon a microscopical examination of 
the urine. Pus, and the cells characteristic of the 
epithelium of the pelvis, being found therein are 
indicative of this condition. In addition we may 
find coagulae of blood, necrotic mucous tissue, and if 
Strongylus gigas is the exciting cause, ova of this 
parasite. There is often difficulty in urination and 
colicky attacks of pain. 

Treatment. — In addition to the treatment recpiired 
for the primary disease, antiseptics and astringents 
should be administered. (Jf these formin ( hexame- 
thylenetetramin) is most effectual, exerting its 
antiseptic action by the liberation of formic alde- 
hyd along the whole urogenital tract. In chronic 
cases buchu and juniper in doses of one to two 
ounces may be given with l)enefit. For the pain, 
give Cannabis indica in doses of from one to two 
minims of the fluid extract. 

Degenerations and Tumors 

Neither of these conditions is of much interest, 
from a clinical point of view, since in the dog their 
diasfnosis is most uncertain and treatment useless. 



88 CANINE MEDICINE AND SURGERY 

Parasites 

The parasite with which we are chiefly concerned 
is the Strongylus gigas, a nematode worm usually 
of a blood-red color, slightly tapering at the ex- 
tremities. Its length may reach three feet. The 
ova are oval in shape and brownish in color, appear- 
ing granular or pitted on the surface. The diag- 
nosis of infestation by this parasite can be made 
with certainty by the discovery of the ova in the 
urine by microscopic examination. Suspicion of this 
parasitism should be aroused by frequent attacks 
of renal colic, hematuria, rabiform symptoms, and 
emaciation. 

The treatment consists of repeated small doses, 
from five to ten minims, of oil of turpentine. 

Diabetes Insipidus 

This is a rare disease in the dog, characterized by 
an abnormal increase of the urinary secretion. It 
is most frequently found in young animals, and may 
be ascribed as due to some derangement of the 
nervous system possibly affected reflexly from the 
intestinal canal. Pressure on the brain caused by 
neoplasms has also been noted as a possible cause. 

Diabetes Insipidus is classed with diseases of the 
kidney because an increased functionating of this 
organ is the most noticeable symptom. It is prob- 
able that it should be discussed with diseases of 
the nervous system. 

Symptoms. — Increased thirst, emaciation, and the 
passage of large quantities of pale-colored urine of 
low specific gravity characterize this disease. 

Treatment. — A meat diet, avoidance of cereals, 
and exercise are essentials in the treatment. Codein 
in doses beginning with one third to one grain and 



DIABETES 89 

tincture of valerian, one half to one dram three 
times daily, are the therapeutic indications. 

Diabetes Mellitus 

For a discussion of this disease see the preceding 
section on "Disease of the Liver." 



SECTION X 

DISEASES OF THE BLADDER 

DISEASES of the bladder, while not very com- 
mon, are numerous, including cystitis, spasm 
of the sphincter vesicae, paralysis of the sphincter 
vesicae, lithiasis, retroflexion, new growths, prolapse, 
and eversion. 

Cystitis 

Cystitis consists of a catarrhal inflammation of 
the mucous coat of the bladder. 

Etiology. — Pyogenic bacteria, colon bacilli, and 
other organisms may gain access to the bladder 
from the kidneys, during the course of septic dis- 
eases, from an extension of an infection in a near-by 
organ (uterus or vagina) or from the surrounding 
tissues, and from the introduction of a dirty catheter. 

Cystitis may also be produced by chemical irri- 
tants, such" as cantharides, turpentine, and phenol 
administered internally or absorbed through the 
skin or wound surfaces and eliminated in the urine ; 
by irritation of a cystic calculus ; by prolonged 
retention of urine ; by hypertrophy of the prostate, 
and by traumatisms resulting from kicks or being 
run over. 

Symptoms. — The irritable condition of the bladder 
is shown by the patient's frequent desire to micturate 
and by the increased amount of urine passed in the 
twenty-four hours (the normal amount of urine voided 
in twenty-four hours is seventeen to fifty ounces, de- 
pending upon the size of the animal). The amount 
passed, however, at each act of urination is usually 
small and often accompanied by pain. 

90 



CYSTITIS 91 

The urine is turbid and darker in color than nor- 
mal and is usually alkaline in reaction (normal 
urine in the dog is acid), although where the colon 
bacillus is the causative agent the urine is acid. 
On microscopical examination the urine is found 
to contain mucus, i)us cells, bladder cells, bacteria, 
and often blood corpuscles. The salts in the urine 
are also greatly increased during attacks of cystitis, 
the triple phosphates predominating. 

Examination of the bladder per rectum is painful, 
and in many cases, especially when the disease has 
become chronic, the walls of that viscus are found 
to be greatly thickened. If the exciting cause be a 
calculus, palpation of the bladder through the rec- 
tum will reveal its presence. The temperature as 
a rule does not run high, the fever being of a remit- 
tent type. 

The appetite is suspended and the patient suffers 
from general malaise. The chief complications to 
be dreaded in cystitis are an extension of the in- 
fection up the ureters, with consequent involvement 
of the kidneys (nephritis or pyelonephritis) and rup- 
ture of the bladder from necrosis of its walls. 

In chronic forms of cystitis the symptoms are 
not so evident, the most prominent being incon- 
tinence of urine, and the microscope must be relied 
upon to complete the diagnosis. The walls of the 
bladder in these cases, as stated above, are found 
,upon examination per rectum to be greatly thickened. 

Treatment. — The treatment of cystitis must be 
dietetic, medicinal, and local. In every case the 
diet must be of a non-irritating character, milk be- 
ing the ideal food. Barley water ad libitum should 
also take the place of ordinary water, and should 
be kept constantly before the patient. Among the 
medicinal agents used for this condition are formin, 
lithium benzoate, ammonium benzoate, hyoscyamin. 



92 CANINE MEDICINE AND SURGERY 

potassium bicarbonate, and biichu. Convenient for- 
mulas are as follows: 

^ Liithii carbonas grs. ii 

Formin grs. v 

Sodii benzoates grs. v 

M. et f. tablet No. XXX. 
Sig. — Give one tablet in water every three hours. 

IJ Potassii bicarbonas dr. iii 

Tinct. hyoscyami. 
Fl. Ext. Tritici. 

Syr. auranti aa oz. 1 

Aquae qs. ad oz. iv 

Sig. — Give two drams three times daily. 

In chronic cases buchu, copaiba, santal oil, or 
other stimulating" diuretics should be substituted 
for the above. If pain and spasm are prominent, 
use 1-200 grain of hyoscyamin, sufficient to control. 

The local treatment consists of washing out the 
bladder, after catheterization, with, first of all, tepid 
water, and then with a two-per-cent solution of boric 
acid. If in addition to the other symptoms hemor- 
rhage is constant or severe, the boric-acid solution 
should be replaced with a 1 to 10,000 solution of 
adrenalin hydrochlorid. In very acute cases, where 
there is much pain and tenderness, hot fomentations 
to the posterior portion of the abdomen gives much 
relief, and should always be applied. 

Spasm of the Sphincter Vesicae 

This condition more often affects well-broken 
house dogs which are not afforded an opportunity of 
relieving themselves and whose cleanly instincts 
will not allow them to do so in the house. The 
long voluntary control over the sphincter finally 
gives way to uncontrollable spasm, and the patient 
is unable to urinate when the opportunity arises. 

Symptoms. — Repeated but ineffectual efforts to 



PARALYSIS OF THE SPHINCTER 93 

urinate, pain, great discomfort, and anxious ex- 
pression are evidence of the trouble. Upon exami- 
nation the bladder is found to be cjuite full and 
often enormously distended. If not relieved, rup- 
ture is almost always the result, although in some 
cases the patient dies, exhibiting symptoms of 
uremic poisoning. The symptoms of rupture of 
the bladder are sudden collapse, constant pain, the 
presence of fluid (urine) in the abdominal cavity, 
and upon examination (palpation and catheteriza- 
tion) the bladder is found to be empty. 

Treatment. — As soon as spasm of the sphincter 
vesicae is recognized the bladder must be emptied, 
great care being taken, because of the danger of 
rupture, that the patient does not struggle. If an} 
difficulty is experienced in passing the catheter the 
attempt should be abandoned and the bladder 
emptied by puncturing it through the abdominal w^all 
with a fine trocar and cannula. The puncture is 
made immediately anterior to the os pubis, just to 
one side of the penis in the male and in the median 
line in the female. In any event, when the catheter 
is being passed or when the trocar is being inserted 
the patient should be in a standing position. 

Hyoscyamin sulphate, 1-60 to 1-30 of a grain, or 
tincture of hyoscyamus, one half to four drams, 
should then be given to overcome the spasm. 

Paralysis of the Sphincter Vesicae 

The condition is often associated with chronic 
cystitis, continued overdistention causing weakening 
of the bladder walls and spasm of the sphincter. 
Spinal diseases, general debility, and old age are 
further causes. 

Symptoms. — Constant dribbling of urine, while 
upon examination the bladder is found to be empty, 
is evidence of paralysis of the sphincter. 



94 CANINE MEDICINE AND SURGERY 

Treatment. — This must be directed to correcting 
the primary condition. If the trouble is caused by 
old age or debility the patient should be given a 
good nerve tonic, such as the triple arsenates or 
other good tonics containing strychnin, and every 
means taken to improve the animal's general con- 
dition. Cantharidin, 1-1000 grain, often works won- 
ders in this condition, and should be given a trial. 
A good combination is one grain each of pulverized 
cantharides and of pulverized nux vomica, given 
twice daily in capsule or pill. 

Lithiasis 
(Stone in the Bladder) 

This condition is more common in dogs than is 
generally supposed, since until the calculus has at- 
tained a fair size, few symptoms manifest them- 
selves, a slight cystitis often being the only symp- 
tom noticed. When, however, the stone becomes 
large enough to either partially or completely 
obstruct the neck of the bladder the following 
symptoms appear : 

Symptoms. — The patient becomes very restless, 
constantly looking round to his hind quarters and 
whining. He frequently places himself in the posi- 
tion to urinate, but either accomplishes nothing or 
succeeds in passing only a few drops of urine, which 
are often followed by blood. The appetite is sus- 
pended, the abdomen becomes, distended and pain- 
ful on manipulation, the back is arched, and the 
patient straddles and staggers in his gait. If not 
relieved, the bladder either ruptures or the patient 
dies of uremia and exhaustion. If a catheter is 
passed it will go only as far as the neck of the 
bladder and cannot be introduced into that organ, 
being stopped by the calculus, consequently no urine 
will be liberated through it. 



TUMORS 95 

In the bitch the stone may be discovered by the 
catheter striking it ; in the dog, rectal examination 
will make the diagnosis positive. 

Treatment. — The treatment is purely surgical and 
is described on page 213. As cystitis is nearly 
always associated with vesical calculi the treatment 
given for that condition should be followed until 
the calculus is removed surgically and the cystitis 
overcome. 

Retroflexion 

In this condition the bladder is turned backwards 
toward the perineal region, often causing it to bulge 
outward (perineal hernia), and sometimes twisted 
at its neck. 

Causes. — Retroflexion of the bladder may be pro- 
duced by a prolonged distention of the bladder, with 
consequent attenuation and weakening of its walls. 
New growths^^'(pressure), prostatitis, tumors of the 
prostate gland, constipation, and trauma are further 
causes. 

Symptoms. — This condition results in partial or 
complete retention of urine, with its accompanying 
symptoms. If twist has taken place the catheter 
cannot be passed. Rectal examination reveals the 
malposition of the bladder, the condition of the 
prostate, and the occurrence of new growths in the 
immediate neighborhood. If perineal hernia exists 
the contents of the hernial sac may be ascertained 
by puncture, and thus the diagnosis positively made. 

Treatment. — This is entirely surgical, and is de- 
scribed on page 217. 

Tumors 

The new growths of the bladder most commonly 
met with are papilloma, sarcoma, carcinoma, myx- 
oma, and fibroma. They may occur either outside 
or inside the bladder wall. 



96 CANINE MEDICINE AND SURGERY 

Symptoms. — In the early stages, hematuria may 
result from tumors of the bladder, but later there 
is pain on urination and the usual symptoms of 
cystitis. In the last stages the patient becomes 
emaciated and anemic, and the urine fetid and puru- 
lent. The presence of the tumor may be diagnosed 
by the use of the catheter or sound, and by rectal 
examination. 

Treatment. — Treatment consists of suprapubic 
cystotomy and removal of the new growth. This 
operation is described on page 213. 

In the majority of the cases the prognosis is un- 
favorable. 

Prolapse 

This accident occurs only when the lower wall 
of the vagina has been ruptured during parturition. 
The bladder escapes through the rent and may pro- 
ject beyond the vulva. The condition may be dis- 
tinguished from eversion of the bladder by the fact 
that the bladder is covered with serous membrane 
and contains urine or gradually tills up with urine. 
In inversion, the bladder is turned inside out, the 
mucous coat being exposed, and the openings of 
the ureters, from which drops of urine will be dis- 
charged, are easily seen. In addition, examination 
of the vaginal floor reveals the rupture through 
which the organ has protruded. 

If prolapse' of the bladder is neglected, inflamma- 
tion followed by necrotic changes will take place in 
the bladder walls, rendering the prognosis grave. 

Treatment. — Provided the serous coat is little 
changed, it must be carefully cleaned with anti- 
septics, emptied of its contents and pushed back 
into position, and the tear in the vagina sutured". 
The patient should then receive an anodyne to pre- 
vent straining. 



EVERSION OF THE BLADDER 97 

Eversion 

This may occur from the same causes that pro- 
duce prolapse, from which it differs only in that the 
bladder is inverted upon itself and that it may 
occur without rupture of the floor of the vagina. 
It is differentiated from prolapse by the symptoms 
given under that head. Remedial measures dififer 
somewhat. 

Treatment. — In inversion, after thoroughly clean- 
ing the mucous coat the hind quarters of the patient 
are elevated and the bladder pushed back through 
the uretha with the finger or a smooth rounded 
article, such as a thermometer or fountain-pen case. 
The bladder must then be washed out with a two- 
per-cent solution of tannin, and straining prevented 
by anodynes — such as H-M-C or morphin. In cases 
of recurrence, laparotomy may be performed and the 
bladder sutured to the abdominal walls, thus effect- 
ually preventing further trouble. 



SECTION XI 

DISEASES OF THE PROSTATE, URETHRA 

AND PREPUCE 

Urethral Calculi 

CALCULI in the urethra are very common in 
certain districts and cause great pain and dis- 
tress to the patients afflicted with them. The cal- 
culi may lodge anywhere in the urethra, but are 
more often found at or near the posterior extremity 
of the OS penis. They vary greatly in size. 

Symptoms. — The symptoms of urethral calculi are 
similar to those of cystic calculi. The animal is 
restless and evinces pain ; makes frequent but unsuc- 
cessful, or but partially successful, attempts to uri- 
nate ; there is some discharge of blood ; the 
abdomen becomes enlarged and is painful on ma- 
nipulation ; the bladder is tightly filled and finally 
ruptures if not relieved or if death from uremic 
poisoning does not supervene. The absence of the 
stone in the bladder and the limited distance that 
the catheter can be introduced are means of dif- 
ferentiating between cystic calculi and urethral 
conditions. 

Treatment. — If the bladder is much distended it 
must be evacuated by suprapubic puncture. A 
catheter should be passed up the urethra to the 
calculus, an incision made down to it, and the cal- 
culus removed. The wound is best left unsutured 
and treated as an open wound. 

Urethritis 
(Catarrhal Inflammation of the Urethral Mucosa) 

Urethritis is the result of infection which n^ay 
extend from the bladder, be introduced by a dirty 

98 



PROSTATITIS 99 

catheter, or during coitus come from a female that 
is sufifering from leukorrhea or endometritis. It is 
also seen as an accompaniment of distemper. True 
gonnorrheal urethritis is not a canine disease, but 
the author has seen one case of urethritis in the 
dog in which the gonococcus was identified beyond 
dispute, on microscopic examination. The bacteria 
usually associated with non-specific urethritis are 
the pyogenic organisms, staphylococci, micrococci, 
and streptococci. 

Symptoms. — A sticky mucopurulent discharge 
from the penis, signs of cystic irritation and an 
inflamed appearance of the prepuce and meatus are 
the chief indication of this disease. 

Treatment.^Urinary antiseptics must be employed 
in this condition. Forniin in five-grain doses has 
given the author better results than anything else. 
Local treatment is also indicated, and consists of 
syringing the urethra three times daily with an 
antiseptic, such as a one-per-cent solution of potas- 
sium permanganate or a five-per-cent solution of 
protargol. 

Prostatitis 

Inflammation of the prostate gland usually occurs 
in connection with some other inflammatory condi- 
tion, such as cystitis, urethritis, cystitic calculi, con- 
stipation, or proctitis. The gland frequently sup- 
purates, and the abscess may discharge into the 
urethra, or into the abdominal cavity and cause 
peritonitis and even death. 

Symptoms. — Great pain is experienced by the 
afflicted animal when either urine or feces are passed. 
Retention of the urine and obstinate constipation 
often result from prostatitis both because of the 
mechanical obstruction of the enlarged gland and 
because of the patient delaying the act as long as 



100 CANINE MEDICINE AND SURGERY 

possible to avoid the pain. Upon rectal examina- 
tion the prostate is found to be enlarged, hot, and 
])ainful (in palpation. 

Treatment. — The patient siiould receive a laxative, 
repeated as necessary to keep the feces soft and 
overcome constipation. Hot rectal injections give 
relief from the pain and an anodyne suppository 
introduced into the rectum, after an enema, also 
gives good results. If pus forms, indicated by 
fluctuation and a rise of temperature, it must be 
evacuated through the rectum after the introduction 
of a speculum. 

Hypertrophy of the Prostate 

This condition is seen most frequently in old 
dogs, and is often the result of prostatitis. The 
whole gland becomes enlarged, though one side is 
usually larger than the other. To the touch, the 
gland is neither hot nor sensitive. It may feel hard 
or soft, according to whether the enlargement is 
due to hyperplasia of the fibromuscular tissue or to 
infiltration of the gland with purulent fluid. 

Treatment. — Laxatives should be administered as 
required to regulate the bowels ; tonics should be 
given and a generous, nutritious diet supplied. For 
direct action on the gland itself, administer four 
grains of chromium sulphate twice daily over a 
considerable period of time. 

Castration has a very beneficial efl:"ect in many 
cases, the gland becoming gradually smaller with 
the lapse of time. However, the chromium-sulphate 
treatment should be tried first. Potassium iodid 
administered internally and the injection of iodin 
into the gland have been tried, but the results are 
by no means satisfactory. 



PARAPHIMOSIS 101 

Tumors of the Prostate 

Carcinoma, adenoma, and sarcoma arc the prin- 
cipal new growths afifecting the prostate and (hiring 
life can be differentiated from hypertrophy of thai 
organ only by the gradual loss of condition and 
emaciation of the patient. 

Treatment is useless, as the surgical removal of 
the prostate is not possible. 

Phimosis 

Phimosis is the contraction of the prepuce over 
the free end of the penis. It is often congenital, 
but is sometimes caused by injury to the prepuce, 
and subsequent inflammatory swelling, that leaves 
it thickened or contracted. 

Treatment. — Remedial measures are necessary 
only when the constriction interferes with coitus, and 
is usually attempted only in stud dogs. It consists 
in enlarging the opening of the prepuce with a 
probe-pointed bistoury, sufficiently to allow free 
protrusion of the penis. 

Paraphimosis 

Paraphimosis is the opposite condition from phimo- 
sis — constriction of the prepuce behind the glans 
penis. This usually occurs after coitus, the swelling 
of the glans during the act of copulation making it 
impossible for the animal to withdraw the penis into 
the prepuce. 

Treatment. — First of all, treatment consists in trying 
to reduce the swollen glans penis with cold astrin- 
gent lotions and pressure exerted on the end of the 
penis, while at the same time an efifort is made to 
push the prepuce forward over the glans. These 
means failing, the constricted portion must be di- 
vided with a probe-pointed bistoury, as in phimosis. 



102 CANINE MEDICINE AND SURGERY 

Tumors of the Glans, Prepuce, and Vagina 

The principal neoplasms occurring of the glans, 
prepuce, and in the vagina are carcinomas, sarcomas, 
and granulomas (contagious). 

Treatment. — Complete surgical removal of these 
tumors should be resorted to where possible, either 
by means of the scalpel or ecraseur, the resulting 
hemorrhage being controlled by pressure, or, if 
necessary, by thermocautery. 



SECTION XII 

DISEASES OF THE TESTICLES AND 
SCROTUM 

Orchitis 

Inflammation of the testicles, except from tranma, 
is exceptional in the dog. It is usually caused by 
kicks, blows, or from crushing, though it sometimes 
occurs during the course of distemper and other 
contagious diseases. 

Symptoms. — The affected testicle is swollen, hot, 
and painful on manipula,tion, the scrotum appear- 
ing smooth, tense, and glistening. There is generally 

"considerable constitutional disturbances, indicated 
by a rise of temperature, anorexia, and a quick, full 
pulse. The patient shows a disinclination to move 
about much, and when forced to do so walks with 
a straddling movement of the hind legs. 

Treatment. — A brisk purge should be given, fol- 
lowed up by such febrifuges and sedatives as symp- 
toms indicate. Hot fomentation must be applied 
to the scrotum or, if preferred, antiphlogistin may 
be applied in a thick layer as hot as the patient can 
bear it, and covered with absorbent cotton. In 

"either case the testicles must be supported by a 
properly applied suspensory until pain and swelling 
have subsided. Inunctions, after fomentation, of 
hot camphorated oil are particularly beneficial and 
are preferable to belladonna ointment in being non- 
toxic. 

Abscess of the Testicle 

Abscesses sometimes afifect the testicles or scro- 
tum. This constitutes essentially a suppurative 

103 



104 ^ CANINE MEDICINE AND SURGERY 

orchitis and may be due to the same causes as 
orchitis, enumerated above. 

They are treated by incision, drainage, and the 
usual antiseptic measures. In some cases castration 
is the only satisfactory means of dealing with sup- 
puratixe conditions of these parts. 

Tumors of the Testicles and Scrotum 

The neoplasms commonly affecting the scrotum 
and testicles are carcinoma and sarcoma. They are 
best treated by castration, removing the entire 
scrotum if necessary. 



SECTION XIII 

DISEASES OF THE HEART AND BLOOD 
VESSELS 

Pericarditis 

IN canine patients in the vast majority of cases 
pericarditis is idiopathic and not traumatic. It 
is usually developed in the course of a general in- 
fectious disease, such as acute muscular and articu- 
lar rheumatism, septicemia, pneumonia, or pleurisy. 
Traumatic causes may be fractured ribs, punctured 
wounds of the thorax, or foreign bodies such as 
needles and fish bones. 

Symptoms. — The disease passes through two 
stages, the dry and the moist or exudative stage. 

In the first stage the heart's action is palpitating 
and tumultuous, and there is a high fever up to 105 
degrees Fahrenlieit. The ])ulse is wiry and fast; 
dyspnea is present. Cardiac dullness extends upward 
and backward, and friction sounds are present. 

In the second stage, after exudation has taken 
place the heart sounds are diminished and friction 
sounds absent. The pulse is small, rapid, and irregu- 
lar, and the jugular pulse is seen. There is great 
dyspnea, cyanosis, ascites, and marked emaciation 
and debility. 

Treatment. — Absolute rest and quietness must be 
enforced and an ice pack applied over the cardiac 
region. Good results are also obtained by the appli- 
cation of a mustard poultice. The heart's action 
must be regulated by the internal administration of 
from ten to twenty-five minims of tincture of Stro- 
phanthus every two hours and 1-800 grain of aconitine 

105 



106 CANIiNi^ MEDICINE AND SURGERY 

every fifteen minutes to effect, then every hour to 
maintain the effect. In the second stage, when the 
high fever has subsided, give 1-64 grain of digitalin 
and 1-100 grain of strychnin three times a day. 
Continue the aconitin if the temperature rises above 
102 degrees Fahrenheit. In addition to the above, 
five to fifteen grains of potassium iodid three times 
daily should be given in milk to assist in the absorp- 
tion and elimination of the exudate. The bowels 
must be kept active with repeated doses of calomel, 
and stimulants must be given if necessary. In 
cases of great eft'usion of exudate, paracentesis peri- 
cardii must be performed early. The operation con- 
sists of introducing a fine trocar and cannula, with 
all aseptic precautions, through the sixth intercostal 
space, low down near the sternum and into the 
pericardial sac, and allowing the fluid to drain away. 

Acute Endocarditis 

Acute endocarditis, or acute inflammation of the 
endocardium, is by no means such a rare condition 
as is generally thought. In the generality of cases 
it is produced by the entrance of bacteria into the 
blood stream. It is a sequel to septicemia, pyemia, 
septic metritis, distemper, and rheumatism. 

Symptoms. — There is tempestuous heart action, 
with a palpitating, irregular, and later diffused beat. 
The number of heartbeats frequently outnurftber the 
pulse rate, which often varies from 120 to 240 a 
minute. In addition to its rapidity the pulse is 
irregular, intermittent, and very weak, often barely 
perceptible. The heart sounds, at first normal, be- 
come blurred, the first often running into the sec- 
ond, so that it is hard to distinguish them. Later, a 
blowing sound is heard during systole and a pro- 
longed rustling or vibrating during diastole. The 
temperature rises to 105 or 106 degrees Fahrenheit, 



ENDOCARDITIS 107 

and great difficulty in breathing and quickened res- 
piration are noticed. Acute endocarditis may lead 
to death within a few hours, be prolonged for weeks, 
or merge into the chronic form. 

Treatment, — Absolute cjuietness and the avoid- 
ance of all excitement are essential. The heart's 
action must be regulated by the administration of 
digitalin and aconitine, and an ice pack or counter- 
irritant applied to the cardiac area. Staphylobac- 
terins have in many cases given good results, and 
should be given a trial. 

Chronic Endocarditis and Valvular Defects 

Chronic endocarditis usually leads to valvular de- 
fects, which are inability to close or stenosis. The 
inability to close, or insufficiency, arises from shrink- 
age of the valve itself and shortening of its ten- 
dinous fibers, this preventing the valve from com- 
pletely closing the opening which it guards. Insuf- 
ficiency and stenosis of the orifices usually go hand 
in hand, the result being certain secondary an- 
atomical changes in the body, as hypertrophy and 
dilatation of the heart, engorgement of the liver, 
kidneys, and spleen, dropsy (ascites) of chest and 
abdomen, anasarca, and emaciation. 

Stenosis is produced by the thickening of the 
valves and endocardium, the edges of the orifice 
and of the valves sometimes being covered with 
polypi-like growths or vegetations. Both orifices 
and valves lose their elasticity and mobility, pre- 
venting the normal amount of blood being driven 
through without increased force. 

Symptoms. — The general symptoms of valvular 
defects are an easily excited activity of the heart 
with acceleration of the pulse and beat, palpitation, 
an irregularity of beat and pulse, abnormal sounds 



108 CANINE MEDICINE AND SURGERY 

during diastole and systole, dyspnea upon exertion, 
vertigo, rapid exhaustion, emaciation, cyanosis of 
visible mucous membranes, ascites, anasarca, albu- 
minuria, and diminished renal secretion. 

Insufficiency of the mitral valve causes a back 
flow of blood into the left auricle during systole, 
producing a blowing or hissing sound as the systole 
is completed. The diastole sound is abnormally 
pronounced, there is dyspnea, feeble pulse, and 
engorgement of the venous system. 

The characteristic symptoms of mitral stenosis 
are diastolic after-sounds, loud pulmonary tone, very 
small pulse, dyspnea. 

Insufficiency of ihe iricuspid causes a regurgitation 
of the blood from the right ventricle into the right 
auricle, with sharp systolic after-sounds, cyanosis, 
ascites, engorgement of the lungs and venous pulse. 

Insufficiency of the aortic valves causes a back flow 
from the aorta into the left ventricle during diastole, 
producing a whirring diastolic after-sound. The 
pulse is strong, rapid and jumping — pulsus celer. 

Stenosis of the ventncular aortic orifice gives systolic 
after-sound, slow, feeble pulse, and in extreme cases 
cerebral anemia. 

Insufficiency of the pulmonary valves gives rise to a 
diastolic after-sound, fee'ble heart action, and great 
dyspnea. 

Treatment. — Up to a certain point valvular defects 
are compensated for by hypertrophy of the auricles 
or ventricles, and in addition to good feeding and 
freedom from exertion require no medicinal treat- 
ment. In time, however, compensation relaxes and 
disturbances are set upon the lungs and venous sys- 
tems. In these cases it is necessary to regulate the 
action of the heart, reduce the pulse rate, and in- 
crease arterial pressure. For this purpose the ideal 
drug is digitalis; it equalizes the disturbed circula- 



CARDIAC HYPERTROPHY 109 

tion, raises arterial pressure, and lessens the fre- 
quency of the pulse. The infusion of the leaves, 
thirty grains of the leaves to eight ounces of water, 
may be given in doses of one to four drams daily. 
In dropsical cases a diuretic should also be given, 
such as acetate of potash, iodid of potash, squill, 
and so on. Ascitic conditions may be temporarily 
relieved by puncture ; palpitation and excitement by 
1-8 to 1-4 grain of morphin, hypodermically injected. 
In cases of great prostration give stimulants such 
as strychnin, brucin (for puppies), whisky, ether, or 
camphor. 

Hypertrophy and Dilatation of the Heart 

This affection consists of enlargement of the heart, 
increased thickness of its muscular walls, and en- 
largement of its cavities in dilatation of the heart. 
The heart, or portion of it affected (usually the 
right side), is enlarged, but the walls relaxed and 
thinner and its cavities distended. Since from a 
clinical standpoint both hypertrophy proper and 
dilatation of the heart are so closely allied as to make 
it almost impossible to differentiate between them, 
they are here considered together. Dilatation is 
nearly always secondary to hypertrophy and appeag- 
when the hypertrophic heart begins to fail to meet 
the increased demands made upon it. 

Causes. — Increased physical exertion, which occurs 
in racing or hunting dogs as the result of continued 
severe exertion, is a frequent cause of hypertrophy 
and dilatation of the heart. 

Obstacles to circulation in the blood vessels, such 
as aortic aneurysms, stenosis of the aorta, thrombi, 
and pressure of neoplasms on the aorta, degenerative 
processes in the large vessels, are further causes, as 
well as valvular defects producing compensatory 
hypertrophy, lung diseases, emphysema of the lungs. 



110 CANINE MEDICINE AND SURGERY 

tuberculosis, pneumonia, pericardial adhesions, and 
chronic nephritis. 

Symptoms. — Extension of the area of cardiac dull- 
ness is an evidence of the disease, as well as dysp- 
nea, vertigo, disturbances of the circulation, and 
tumultuous heart action. The heart sounds are 
irregular, the first loud and vibrating, the second 
weak and sometimes inaudible. The pulse is weak, 
irregular, and rapid, and there is a venous pulse. 

In addition to the cardiac symptoms proper, con- 
sequent upon the disturbances of the circulation, 
secondary symptoms arise. These may be chronic 
bronchitis, intestinal catarrh, albuminuria, marantic 
thrombosis of the arteries, general cyanosis, dropsy, 
and emaciation. 

Rupture of the Heart 

The heart may be ruptured by violence or the 
walls may give way after being weakened by de- 
generative processes. Death is practically instan- 
taneous if the rupture is large ; if small, death 
may be deferred for a few or several hours. The 
symptoms are often the uttering of a loud cry, 
vertigo, trembling, dyspnea, convulsions, and anemia 
of visible mucous membranes. 



S E C T I O N X I V 

DISEASES OF THE BLOOD AND BLOOD 

VESSELS 

Aneurysms 

ANEURYSMS are true and false, the former con- 
sists of a dilatation of the walls of an artery, 
which is filled with blood, in the latter all the coats 
■are ruptured but the blood is retained by the sur- 
rounding tissues. 

Symptoms. — The general symptoms of aneurysms 
are: The formation of a pulsating tumor; a peculiar 
bruit heard over the swelling and pressure symp- 
toms, consisting of pain and paralysis from pressure 
on nerves and absorption of contiguous parts. The 
aorta is the artery most commonly afifected. 

Treatment. — There is no effectual treatment, but 
rest and avoidance of excitement or exertion may 
defer rupture and death. In rare cases, where only 
a small artery is afTected and the collateral circula- 
tion good, the aneurysm should be removed by first 
ligating the artery above and below and then ex- 
cising it. 

Hematozoa 

The commonest and most important hematozoa 
in our patients are the Filaria immitis, the Strongy- 
lus vasorum, and the Spirotera sanguinolenta. 

Filari Immitis 

This parasite is found in localities rich in marshes 
and surface water. It is supposed, though not defi- 
nitely proved, that such stagnant waters become 
infected by the embryos of the parasite by means of 

111 



llii CANINE MEDICINE AND SURGERY 

the mosquito, which sucks them up from an infected 
animal. An animal drinking this infected water 
develops the mature form in its blood. The mature 
forms chiefly inhabit the right heart and pulmonary 
artery, while the embryos can be detected in the 
blood drawn from the peripheral circulation during 
the night, but retire to the deeper blood vessels dur- 
ing the day. 

Symptoms. — In a great many cases no symptoms 
of a general disturbance to health are manifested. 
Sometimes death is sudden or has been preceded 
for only an hour or so by labored breathing and 
convulsions. More frequently, however, for several 
days before death the patients exhibit dullness, de- 
bility, and more or less frequent epileptiform seiz- 
ures. Epistaxis, lameness, and paralysis are also 
observed in some cases. 

Strongylus Vasorum 

This parasite also inhabits the right heart and 
pulmonary artery, producing endocarditis, throm- 
bosis, and embolism. 

Besides its usual habitat in nests in the mucous 
membrane of the esophagus and stomach. 

Spiroptera Sanguinolenta 

The Spiroptera sanguinolenta also invades the blood 
vessels, producing arteritis and thrombosis. 

Treatment. — In all of the above infestations treat- 
ment is unsatisfactory; but turpentine, in doses of 
half a dram to a dram, given in emulsion with milk 
or mucilage, has given some good results. Upon a 
definite diagnosis being made by finding the em- 
bryos in the blood an intravenous injection of sal- 
varsan suggests itself as a rational nnule of treatment. 



SECTION XV 

DISEASES OF THE NERVOUS SYSTEM 
Encephalitis 

CLINICALLY, it is almost impossible to differ- 
entiate between inflammation of the brain sub- 
stance and inflammation of its coverings, since the 
symptoms are essentially the same, and also because 
when one is affected the others are also. 

It is most convenient to subdivide brain inflam- 
mations into the acute and subacute forms. Under 
the former are included all rapidly progressing cases, 
with extreme symptoms of cerebral inflammation — 
that is, excitement — and under the second, those- 
which present signs of depression and are slower in 
their course. 

However, it must be remembered that transitions 
and intermediate stages occur between the two form.s 
and that therefore no strict boundary can be set 
between them. The following brain diseases may 
occur with symptoms of acute encephalitis — hyper- 
emia of the brain, pachymeningitis, leptomeningitis, 
encephalitis, emboli, and abscesses. 

Subacute encephalitis may occur as a sequel to 
the acute form, from poisoning from food stuffs, and 
as a result of toxemia during the course of an infec- 
tious disease. 

Cause. — Exposure to an excessively high tem- 
perature, overexertion, parasites, new growths, em- 
boli, thrombosis, skull traumatisms, otitis media, 
septicemia, and pyemia all cause disease of the en- 
cephalon or the meninges, or both. 

Symptoms. — There are generally premonitory signs 

113 



114 CANINE MEDICINE AND SURGERY 

of the disease, such as restlessness, a desire to hide, 
and timidity. The patient objects to l^eing handled, 
and although ne\er aggressive (see rabies, p. 155) 
will often bite if toviched or disturbed. Loss of co- 
ordination is an early symptom of encephalitis, the 
patient staggering about and blundering into things. 
There is well-marked conjunctival hyperemia, the 
head feels hot, and the pupils are contracted. Ophthal- 
moscopic examination of the fundus of the eye re- 
veals a highly congested condition of the optic 
papilla and blood vessels. 

Fever is usually present, the temperature rang- 
ing from 104 to 107 degrees Fahrenheit in the acute 
form, but in the later stages or in the subacute con- 
dition the temperature may be normal or even sub- 
normal. The pulse at first is full and bounding; 
later on it is slow and feeble, but easily affected by 
outside stimuli. When nearing the fatal termination 
the pulse becomes extremely rapid and weak. 

The respirations are first increased, but later the 
rate sinks below normal ; they are deep and slow, 
and each inspiration is marked by a snoring noise 
(stertor). 

Vomiting, (central) epileptiform spasms, and in- 
voluntary movements are noticed. Later on, the 
patient becomes paralyzed, lapses into coma, and 
dies. Death is frequently very rapid, but chronic 
conditions such as hydrocephalus amaurosis, deaf- 
ness, and so on may develop. 

Care must be taken to differentiate encephalitis 
from rabies, but the mistake can hardly occur if we 
remember that in rabies the typical symptoms are 
aggressiveness, altered voice, and consumption of 
indigestible substances. In rabies, too, the tempera- 
ture of the skull is not so intense nor is the hy- 
peremia of the conjunctiva so well marked. 

Treatment. — The patient should at once be placed 



CEREBRAL HEMORRHAGE 115 

in a cool, dark, but well-ventilated place, and an ice 
pack placed on the head ; or the head may be con- 
tinuously bathed with cold water or even placed 
under a running cold-water tap. In the very early 
stages — that is, when the pulse is full and bounding 
— venesection is of the greatest benefit, but later 
on it is to be avoided as positively harmful. The 
circulation may also be equally well equalized by 
repeated small doses of aconitin and veratrin. A full 
purgative should be given, and the bowels kept well 
relaxed. Great excitement may be controlled either 
by a hypodermic injection of hyoscin, a rectal injec- 
tion of chloral hydrate, or the oral administration of 
potassium bromid. In siib-acute cases, where the 
depression is great, recourse must be had to stimu- 
lants, such as strychnin, camphor, or ether, admin- 
istered hypodermically. 

Later on, if the patient rallies at all, full doses 
of potassium iodid should be given. 

Anemia of the Brain 

In acute cases of anemia of the brain, vertigo and 
unconsciousness are the premonitory symptoms. In 
addition, the heart is weak and the pulse small, 
vomition occurs, the pupils are dilated, and paleness 
of the optic papilla is revealed upon ophthalmoscop- 
ical examination. 

Treatment. — Stimulants (given hypodermically) 
and circulatory equalizers should be administered 
and counterirritants applied to the head. 

Cerebral Hemorrhage 

Apoplexy consists in rupture of a blood vessel in 
the brain, with effusion of blood and compression 
or destruction of the brain parenchyma. 

Cause. — A cerebral hemorrhage may take place 
in connection with encephalitis or from any of the 



116 CANINE MEDICINE AND SURGERY 

causes of that condition. In addition, arterioscle- 
rosis, degeneration of the cerebral arteries, and in- 
creased blood pressure are frequently responsible for 
their rupture. 

Symptoms. — Indications of cerebral hemorrhage 
appear suddenly, and they consist of disturbances of 
the sensorium, vertigo, incoordination and involun- 
tary movements, collapse, and coma. The visible 
mucous membranes of the head are intensely hyper- 
emic, and bleeding may occur from the mouth and 
nose. The pulse is very weak, breathing dyspneic, 
and sometimes involuntary relaxation of the sphinc- 
ters vesicae and ani is noticed. The local symptoms, 
depending upon the location of the effusion, are 
paralysis of single muscles or groups of muscles 
(monoplegia) or semilateral paralysis, hemiplegia, 
paralysis of the optic nerve, paralysis of sensation 
of one half of the body (hemianesthesia), and para- 
lyzed deglutition. 

Monoplegia indicates hemorrhage aft'ecting the 
motor centers of the cerebral cortex, while hemi- 
plegia is a hemorrhage in the region of the path of 
conduction up to the pyramid, paralysis of degluti- 
tion, and hemorrhage into the medulla. 

Treatment. — Any treatment is usually ineft'ectual, 
recovery being only partial, more or less paralysis 
always remaining. 

Absolute quietness and freedom from exciting 
causes are essential. The application of cold packs 
to the head, free purgation, stimulants, and later 
potassium iodid in full doses in the endeavor to cause 
absorption of the eft"usion are about all that can be 
done. Any remaining paralysis should be treated 
by massage, electricity, and the administration ot 
strychnin. 



MYELITIS 117 

Cerebrospinal Meningitis 

This is a rare disease in canine patients. It is of 
nndetermined etiology, and, as its name implies, is 
an inflammation of the meninges of the l)rain and 
spinal cord. 

Symptoms. — Great depression and stupor, trem- 
bling, fever, incoordination, and involuntary move- 
ments are indications of cerebrospinal meningitis. 
The muscles of the neck are hard and prominent 
and in a state of spasm, and spasms may affect the 
whole body, finally causing death by exhaustion. 

Treatment. — The same treatment as that for 
encephalitis, with the addition of full doses of 
H-M-C hypodermically to control the spasms, is 
indicated. 

Myelitis — Meningitis Spinalis 

(Inflammation of the Spinal Cord and Membrane) 

These two diseases are of rare occurrence and 
cannot be distinguished clinically. Their causes arc 
mostly traumatic, blows, shocks, vertebral fractures, 
carious vertebra, metastasis during septicemia, py- 
emia, and distemper. 

Symptoms. — (1) Disturbance of )iiotioii. The gait 
is stiff' and staggering, and there is muscular twitch- 
ing and partial or complete paralysis. The para- 
lyzed limbs are dragged along the ground and are 
irresponsive to the electric stimulus. 

When the cervical portion of the cord is affected 
the four extremities are affected and sometimes the 
pupil of the eye contracted ; when the lumbar por- 
tion is affected, the hind extremities alone are para- 
lyzed. 

2. Disfurhances of sensation occur either in a 
hyperesthesia or anesthesia of the cutaneous nerves. 
The former manifests itself in pain, excitement, and 



118 CANINE MEDICINE AND SURGERY 

excessive tenderness over the spine. The patient 
cries or screams when handled, and may attempt 
to bite when approached ; the reflexes are accentu- 
ated. The latter is recognized by dulled or sus- 
pended reflexes and loss of sensation in the skin, 
which does not respond to any stimuli. 
, 3. Disturbances of ihe bladder and rectum. At 
first both feces and urine are retained on account 
of paralysis of the rectum and detrusor urinse mus- 
cle, while later incontinence of urine and feces takes 
place. 

Treatment. — In the early stages of the disease 
cold applications should be applied to the spine in 
the form of ice packs. Later on, smart counter- 
irritation must be maintained with mustard oil. For 
the paralysis, the induced electrical current should 
be applied and strychnin administered internally. 
Pain is best controlled by H-M-C. The bladder and 
rectum should be emptied, and due attention given 
to the patient to prevent the irritation produced 
from the urine soiling the thighs and belly if incon- 
tinence occurs. 

Apoplexy 

Hemorrhage into the spinal cord may be pro- 
duced by traumatism,, neoplasms, exostosis of the 
vertebrze, emboli, atheromatous degeneration, or 
arteriosclerosis of the spinal arteries. Traumatism 
is by far the most frequent cause, and the lumbar 
region most often affected. 

Symptoms. — The chief symptom is sudden paral- 
ysis, due to pressure of the extravasted blood on 
the cord, and pain on pressure or movement of the 
spine or lumbar region. The patient drags his hind 
legs along the ground, and is unable to stand. More 
rarely, the hemorrhage takes place more anteriorly, 
and complete paralysis ensues. The bladder and 



EPILIPSY 119 

rectum are usually affected, as in inflammation of 
the cord, and the paralyzed muscles do not react to 
electrical stimuli. 

Treatment. — Treatment of apoplexy of the spinal 
cord is fairly successful, but usually of long dura- 
tion. In order to promote absorption of the ex- 
travasated blood, potassium iodid to saturation 
should be given and frequent fomentations applied 
to the spine. The aft'ected muscles should receive 
electrical massages or friction with stimulating lini- 
ments. The bowels must be kept freely active with 
laxatives and enemas, and every attention given to 
the comfort and cleanliness of the helpless patient. 

Epilepsy 

This is a chronic brain aft'ection, with fits of dis- 
turbed consciousness and sensation and accompany- 
ing muscular spasms, between which are varying 
intervals of freedom from symptoms. The condi- 
tion is probably due to some fleeting disturbance in 
the cells of the cerebral cortex and motor cortices 
centers. Its essential causes are not known, but 
there is ample evidence to establish the fact that it 
is undoubtedly hereditary. In individuals predis- 
posed to the disease sometimes an attack is brought 
on by great excitement, sudden fright, or overexer- 
tion. It is a comparatively rare disease in our 
patients, although they frequently suffer from epi- 
leptiform fits, which, however, can generally be ac- 
counted for by injuries to the skull which produce 
concussion of the brain either by depressed frac- 
tures or blood clots, and give rise to epileptiform 
seizures or fits. Fits are also caused by reflex action, 
painful wounds of the extremities, or body, irrita- 
tion of the alimentary mucous membrane by para- 
sites, constipation, and by foreign bodies in the ali- 
mentary tract. Overexertion during excessively hot 



120 CANINE MEDICINE AND SURGERY 

weather, with deprivation of water, is another very 
common cause. 

Symptoms. — The patient, after staggering around 
for a moment or so, suddenly falls to the ground 
in convulsions, uttering loud cries, champing the 
jaws, and frothing at the mouth. The animal strug- 
gles convulsively with its feet, goes into convulsions, 
and loses consciousnes. In some cases the patient 
seems to have an irresistible desire to run, and tears 
along, foaming at the mouth and champing the 
jaws, finally to fall and go into convulsions before 
losing consciousness. These cases generally give 
rise to the cry of "mad dog," the unfortunate only 
too often being mercilessly clubbed to death or 
mangled by ineffective shots from revolvers of zeal- 
ous but incompetent guardians of the law. During 
the fit, breathing is rapid and dyspneic, the pupils 
dilated and insensible to light, reflexes suppressed, 
and the pulse slow, small, and hard. The convul- 
sions sometimes cease suddenly, at other times 
gradually, and often give place to general tetanic 
spasms, during which the involuntary passage of 
feces and urine takes place. When the attack is 
over the patient usually quickly regains conscious- 
ness, but remains exhausted and dazed for some 
time. But sometimes the attack is ended by a deep, 
snoring sleep. In many cases the animal is ex- 
tremely irritable and until completely restored to its 
normal mental equilibrium shows a tendency to 
bite, if handled. Fits may last from fifteen seconds 
to half an hour and recur quite frequently, or the 
periods of intermission may be quite prolonged. 

Treatment. — During an attack very little can be 
done, with the exception of preventing the animal 
from knocking itself about, wedging open the jaws 
to pre\'ent laceration of the tongue, and applying cold 
water or ice to the head. Afterwards all discoverable 



EPILEPSY 121 

causes, such as worms, constipation, and so on, 
must be removed, and in the case of depressed frac- 
tures of the cranium surgical means must be em- 
ployed, if possible, and the patient placed on a 
course of potassium iodid and solanin (one grain) 
three times a day, or one grain of silver nitrate 
daily in three doses. The bromids so long used in 
medicine for the relief of epilepsy do not produce 
what is claimed for them, and certainly are in- 
effective. 

Chorea 

This troublesome nervous infection is discussed 
under distemper (see p. 151). 



SECTION XVI 

DISEASES OF THE EYE 
Conjunctivitis 

INFLAMMATION of the conjunctival mucous 
membrane may vary in its intensity from a sim- 
ple hyperemia to a purulent condition. It is caused 
by foreign bodies — such as small particles of dirt, 
ashes, or metal — by smoke and irritant chemical 
fumes, and by too strong antiseptic washes. It is 
a very frequent sequel to an antiseptic bath given 
for the purpose of getting rid of parasites or even 
from the use of cheap and crude dog soap. Direct 
injury may sometimes be the cause of conjunctivitis, 
and it is often seen as a symptom of some other 
condition. 

Symptoms. — The first symptom usually noticed in 
an acute attack of conjunctivitis is a flow of tears 
from the affected eye, which is nearly or completely 
closed. There is great intolerance to light (photo- 
phobia) and upon examination the conjunctiva is 
found to be congested (hyperemia) and swollen. 
If the case becomes of the purulent variety the 
watery discharge (tears) becomes pus-like and the 
bulbar conjunctiva may become involved, as evi- 
denced by marked pericorneal injection and edema 
around a slightly hazed cornea. In severe cases 
corneal ulcers form from erosion of the epithelium. 
The eyelids often become glued together by the 
discharge, which excoriates their edges and often- 
times the skin of the cheeks. 

Treatment. — The afi:'ected eye should be bathed 
with cold water and then carefully examined for 

122 



KERATITIS 123 

foreign bodies, which should be removed at once 
if detected. If the eye be very sensitive, a few drops 
of a four-per-cent solution of cocain instilled into 
the conjunctival sac greatly facilitates the required 
manipulation. The eye should then be washed with 
a saturated solution of boric acid, a 1-3000 chinosol 
solution, or a two-grain to the ounce solution of 
protargol. If there is much pericorneal injection 
and haziness of the cornea, the pupil should be di- 
lated with homatropin. Excessive pain and irrita- 
tion are nicely controlled by a few drops of a col- 
lyrium containing one grain of cocain and ten grains 
of boric acid to the ounce of water. When the 
acute stage is passed the eye should be frequently 
cleansed with the saturated solution of boric acid, 
and a few drops of a solution of protargol, five 
grains to the ounce of distilled water, instilled three 
or four times a day. Cloudiness of the cornea should 
be treated, after the subsidence of all acute symp- 
toms, with the yellow oxid of mercury ointment, 
one to three per cent. 

Keratitis 

Inflammation of the cornea may be the result of 
infection spreading from an infected conjunctiva or 
introduced by injuries, and it is a frequent symptom 
of distemper. Keratitis is classified as keratitis 
super ficialis, 'keratitis interstitialis, and suppurative kera- 
iii is. 

Keratitis Super ficialis 

Keratitis superficialis should in reality be regarded 
as a disease of the conjunctiva, since it is the bulbar 
portion of that membrane which is afifected, and, 
strictly speaking, not the cornea proper. Conse- 
quently it has been described above under conjunc- 
tivitis. 



124 CANINE MEDICINE AND SURGERY 

Keratitis Inter stitialis 

Keratitis interstitialis is a far more serious con- 
dition, since it involves the corneal parenchyma. 

Symptoms. — It begins with irregularly rounded 
whitish dots which usually appear in the center of 
the membrane. There is haziness, ciliary infection, 
and a marked formation of new vessels. At times 
the opacity is so completely confined to the in- 
terstitial lamina that the cloudy portion of the mem- 
brane looks as if it were covered. As the disease 
progresses the opacities in the lamellae grow larger 
by fusion until the whole cornea may become opaque. 
There is intense ciliary injection, a constant flow 
of tears, and great photophobia. The amount of 
vascularization varies largely in different cases. Ves- 
sels extend in from the superficial and deep loops, 
until at times the entire membrane becomes of a 
dark red tint. Their formation generally occurs in 
that part of the periphery that is nearest the densest 
opacity. When the disease subsides the cornen 
clears from its periphery, the central opacities being 
the last to disappear. The complications are iritis, 
with the formation of posterior synechige (adhesion 
of iris to lens), choroidal degeneration, and retinitis. 

Suppurative Keratitis 
{Abscess of the Cornea) 

Suppurative keratitis in its various forms is due 
to injury and infection or is secondary to disease 
affecting other tissues of the eye or body. 

The most common form is marked by ulceration 
of the cornea, the ulcer sometimes- destroying all the 
layers and causing evacuation of the aqueous humor. 
Usually, however, the ulcerative process stops at 
the membrane of Descemet, which from interocular 
pressure bulges out from the co'rnea, causing the 
condition known as staphyloma. 



KERATITIS 125 

Abscess of the cornea is an exceedingly serious 
condition, the eye nearly always being lost. It gen- 
erally results from injury, with subsequent infection 
by pyogenic organisms. (In such cases we find 
near the center of the cornea a yellowish-gray 
rounded spot, infiltrated with pus cells, with an area 
of swollen tissue around it.) Later the anterior walls 
slough off, and an open ulcer with prominent edges 
is revealed. Soon cloudiness of the aqueous humor 
appears and pus forms in the anterior chamber ot 
the eye (hypopyon). 

The infective processes extend to the iris and 
ciliary body and finally the whole eye becomes in- 
volved, there being no tendency to spontaneous re- 
covery. 

As all varieties of suppurative keratitis are serious 
and threaten the eyesight, treatment should be at 
once instituted and diligently carried out. 

Treatment. — The eye should be frequently irri- 
gated with antiseptic solutions such as chinosol 
(1-2000), a saturated solution of boric acid, or bi- 
chlorid of mercury (1-5000). 

The pupil should be alternately dilated and con- 
tracted by the instillation of solutions of atropin 
(1-100) and physostigmin (1-200) to guard against 
adhesions of the iris. 

The ulcers themselves should be touched up with 
a solution of protargol, five grains to the ounce, or, 
if sluggish, even by thermocautery under cocain 
anesthesia. 

Very small staphylomas should be punctured ; by 
diminishing the intraocular pressure, healing is ac- 
celerated. Partial staphylomas should be ligated 
with a fine silk ligature and ablated three days after 
ligation. 

Abscesses of the cornea should be opened without 



126 CANINE MEDICINE AND SURGERY 

delay with a Graefe's knife after the manner of 
Soemisch. This method consists in introducing the 
knife in the sound corneal tissue on one side of the 
abscess, the back of the instrument being held to- 
ward the center of the eye and its edge turned for- 
ward. Maintaining this position, the abscess is bi- 
sected by bringing the knife out on the opposite side 
of the cornea, the cut being made horizontally. By 
this method the ulcerative process is checked and 
any pus in the anterior chamber evacuated. It must 
be remembered that opening the anterior chamber 
is an essential part of the operation, and responsible 
for its success. 

Opacities of the Cornea 

Corneal opacities are sometimes congenital, but 
generally they are the result of inflammation, injury, 
or ulceration. According as they present a slight haze, 
a defined spot, or a dense and permanent opacity, 
they are termed nebulae, maculae, or leukomata. As 
the tissue of the cornea is resistant and inelastic, 
any loss of substance is made up by exudation and 
subsequent organization of connective tissue and 
epithelium ; consequently the opacity is as large as 
the original loss of substance. Vision is affected 
not only according to their extent, density, and posi- 
tion, but by reason of the alteration which they 
cause in the corneal curvature. 

It is remarkable what great reparative powers 
the corneal tissues have and to what extent the 
effused lymph will clear. Consequently in growing 
animals, with perhaps the exception of the scar left 
by an abscess or deep ulceration, the prognosis of 
good eyesight with any small opaque scar is good. 
With older animals, however, owing to their low 
power of recuperation the prognosis is the reverse. 



IRITIS 127 

Congenital Opacities of the Cornea 

Congenital opacities in many cases clear up or 
diminish a few months after birth, others again per- 
sist, and may cause total blindness. 

Treatment. — The eye should be left alone until 
all active inflammation has subsided, since the ration- 
ale of all treatment is stimulation. 

Solutions of protargol, five grains to the ounce, 
or six-per-cent ammonium chlorid give excellent re- 
sults when instilled into the conjunctival sac three 
or four times a day, but probably the best agent for 
this condition is three-per-cent yellow oxid of mer- 
cury ointment, a small quantity of about the size 
of the head of a match being introduced twice 
daily. 

In persistent cases intramuscular injections of 
fibrolysin should be tried, as brilliant results are 
sometimes obtained from its use. 

Iritis 

Inflammation of the iris is characterized by severe 
pain, especially when the eye is exposed to strong 
light, sluggishness of the pupil, pericorneal injection, 
and change in color from the normal to yellowish- 
red or to red. Synechige are nearly always its 
sequela, and sometimes in cases of profuse exudation 
there is exclusion of the pupil. 

Treatment. — If the eye is protected from light 
and irritants, mild cases of iritis will recover with 
local treatment by atropin, adrenalin, and cocain 
In more severe cases, however, the local treatment 
should be supplemented with corneal puncture (to 
relieve tension) and free purgation (calomel). In 
all cases full dilation of the pupil must be secured 
to guard against or to break down already existing 
synechise. Hot compresses over the affected eye 
and a full dose of H-M-C are of great assistance 



128 CANINE MEDICINE AND SURGERY 

in controlling the severe pains associated with this 
condition. 

Cataract 
(Opacity of the Crystalline Lens) 

The word "cataract" is applied to any opacity or 
want of transparency of the lens, whether partial 
or complete. It may be congenital or it may occur 
at any time in the animal's life. It is often pro- 
duced by wounds of the lens or its capsule, or it may 
be caused by any disease of the eye that seriously 
interferes with the nutrition of the lens. It is a dis- 
ease common to old age, being then caused by im- 
paired nutrition. 

Treatment, — Only recourse to surgery is of any 
avail, and in dogs this gives fairly good results, 
although theoretically it is useless. 

The most practical and successful operation is 
that of discission, which consists of making a 
crucial incision into the anterior capsule of the lens, 
thus allowing access of the aqueous humor, which 
first of all causes swelling of the lens, then its 
absorption. 

The technic is as follows: The patient is anes- 
thetized, the conjunctival sac washed out with a 
1-5000 chinosol solution and then with sterile water, 
and the pupil dilated to its full extent with atropin 
(if H-M-C is used as the anesthetic, this will be 
unnecessary). The eyelids are then held apart with 
an eye speculum, and the discission needle intro- 
duced through the cornea at its lower median peri- 
phery. When the needle reaches the anterior cau- 
sule it is drawn across it twice in a crucial manner 
and slowly and gently withdrawn. Absorption takes 
place in about three months. The after-treatment 
consists in keeping the patient in a darkened kennel 



GLAUCOMA - 129 

until all signs of irritation have subsided, and in 
using mild antiseptic collyria. 

Diseases of the Retina 

Diseases of the retina are not common in dogs, 
the two diseases of this nature most frequently met 
with being detachment of the retina and hemorrhage, 
both being generally the results of traumatisms. 
Beyond allaying pain and irritation very little can 
be done in the way of treatment, blindness always 
being the result in the first instance, and generally 
in the second. 

Glaucoma 

This name is given to a group of eye symptoms 
characterized by periodical obscurations of vision 
in association with an increase of intraocular ten- 
sion, haziness of the cornea, dilatation of the pupil, 
pericorneal venous injection, and a dull purplish 
discoloration situated around the margin of ^ the 
cornea. At times this condition may be accom- 
panied by agonizing pain ; at others no discomfort 
is manifested, but there is a gradual loss of vision. 

When the disease has recurred frequently, excava- 
tion of the intraocular end of the optic nerve takes 
place and atrophy of the entire eyeball ensues. 

There is often total or partial anesthesia of the 
cornea and a characteristic rigidity of the whole eye 
to the touch. 

Treatment. — Treatment is unsatisfactory, but may 
delay or even inhibit the progress of the disease. 

Twenty-four hours previous to operation the pupil 
should be widely dilated with eserin frequently 
instilled into the eye. 

Operation. — With the patient under a general 
anesthetic and with the usual precautions as to 
asepsis, a narrow knife is entered at the cornea- 



130 CANINE MEDICINE AND SURGERY 

scleral junction and thrust out at a similar point on. 
the other side of the anterior chamber. Gare must 
be taken to prevent prolapse of the iris, but should 
this accident occur, the prolapsed portion should be 
removed with scissors and the remainder gently 
replaced. The instillation of eserin will tend to pre- 
vent the prolapse and should be used freely both 
before and after the operation. 

Ailments Amenable to Surgery Alone 
Injuries, foreign bodies, enucleation and other eye 
troubles will be discussed under surgery of the eye 
in Section III (see pp. 194-202). 



SECTION XVII 

DISEASES OF THE EAR 

THE ears, by reason of their exposed position on 
the body, receive injuries as a result of acci- 
dents. These may vary from slight wounds to 
serious lacerations, resulting from fighting, becoming 
entangled in barbed wire, or in running through 
underbrush while hunting. The wounds thus pro- 
duced require treatment on general surgical prin- 
ciples or special operative interference such as will 
be described under plastic surgery of the ear (p. 189). 
Contusions, if severe, produce hematoma, which will 
also be dealt with in a later section (see p. 188). 

The ears are also often affected in the various 
skin diseases, both parasitic and non-parasitic, from 
which our patients suffer. 

Ulceration of the Earflap 

This condition is usually the result of infected 
wounds, the parts becoming infected either by the 
patient's claws, by flies, or by the discharge asso- 
ciated with catarrh of the auditory passarres. It 
produces great irritation, which the patient tr'es to 
relieve by scratching and shaking the head, which 
maneuvers, however, only tend to make matters 
worse. 

Treatment. — First of all, thoroughly cleanse the 
parts, using the curette if necessary, and paint these 
sores with tincture of iodin. The ear should then 
be inclosed in antiseptic gauze and an ear cap, net, 
or bandage applied. The patient must at all costs 
be prevented, either by hobbling or by the use of 

131 



132 CANINE MEDICINE AND SURGERY 

the Elizabethan collar, from scratching or rubbing 
the parts. 

Catarrh of the Auditory Canal 
(Canker) 

Causes. — Dust, dirt, and water getting into the ear, 
either during swimming or while the dog is being- 
bathed, and the ear not being afterwards properly 
dried, are a frequent cause of catarrh of the audi- 
tory canal. Parasites, the symbiotes auricularis var. 
canis, are a not uncommon cause of the trouble. 

Symptoms. — The patient shows great irritation by 
scratching, rubbing, and holding the head with the 
afifected ear downward, and pain is manifested by 
the cries and yelps which accompany any manipu- 
lation of the ear. Upon closer examination, caked 
around the external auditory meatus and matting 
the hair surrounding it, a brownish, sticky discharge 
with a characteristic odor is noticed. If the base 
of the ear is gently pressed a sucking sound is 
heard and the patient evinces pain. In parasitic 
canker the parasites may be discovered by a care- 
ful examination with a magnifying glass. In excep- 
tionally severe and long-standing cases the middle 
and internal ears may become involved, deafness and 
sometimes fatal meningitis being the results. 

Treatment. — The patient should be secured on the 
operating table in the abdominal position and muz- 
zled . to prevent accidents. The ear should then be 
thoroughly but gently cleaned with hydrogen peroxid 
and absorbent cotton swabs. It is essential that the 
whole of the external ear, comprising ear flap, ex- 
ternal auditory meatus, and auditory canal, be cleared 
of every vestige of discharge at the first treatment. 
The ear and canal should then be thoroughly dried 
and the canal filled up with either of the following 
dusting powders: Chinosol (fifteen grains), or for- 



DEAFNESS 133 • 

midiii or aristol, or bismuth formic iodid, and boric 
acid (one ounce). 

An ear cap or bandage should then be applied to 
prevent the patient flapping his ears, and means 
should be taken to prevent scratching of the ear. 
With some very sensitive animals it is a good policy 
to keep them under the influence of H-M-C until 
the irritation has subsided, otherwise it may be im- 
possible to prevent the patient aggravating the trou- 
ble by his ^continual efforts to scratch, rub, or flap 
the ears. 

After the first treatment, all subsequent dressings 
should be in pow^der form, washing the ear or pas- 
sage or the use of lotions or liquids of any descrip- 
tion being only productive of pain. It is surprising 
how even the most obstinate cases of canker yield 
to dry dressing after resisting even the most con- 
scientious treatment with fluid antiseptics. 

In the parasitic form, after cleansing the ear as 
before described, the most efifectual parasiticide is 
one dram unguentum hydrargyri nitratis and one 
ounce oil of almonds, the ear being smeared with 
the ointment and the canal filled with it, and the 
meatus plugged with cotton wool. The ear cap is 
applied as in an ordinary case and the ear cleaned 
up again on the third day, after which the treat- 
ment consists of dr}^ dressings as in simple canker. 

Deafness 

An inability to hear may be either congenital or 
acquired. The former is incurable, and need not be 
considered further. Acquired deafness may be the 
result of an undue accumulation of wax, catarrh of 
the external auditory canal, ulceration of the tym- 
panum, abscess and destruction of the middle ear, 
new growths, or paralysis of the auditory nerve. 

The only cases that are at all amenable to treat- 



134 CANINE MEDICINE AND SURGERY 

ment are those resulting from accumulations of wax, 
some forms of neoplasms (polypi), and canker. 
Paralysis of the auditory nerve occasionally yields 
to the influence of strychnin and a prolonged course 
of tonics. 

Accumulations of wax are best treated by first of 
all filling the external auditory canal with hydrogen 
peroxid, which loosens up the deposit, and then 
removing the wax with forceps, swabs, or an ear 
curette. Ulcers should be first curetted and then 
touched up with a stick of nitrate of silver. Polypi 
are to be ablated either by excision with scissors 
and scalpel or by the use of a small wire ecraseur 
or snare. 



SECTION XVIII 

DISEASES OF THE SKIN 

FROM a clinical point of view the diseases of 
the skin may be considered under two headings 
— parasitic and non-parasitic. 

Parasitic diseases of the skin are produced by 
animal and vegetable parasites, while non-parasitic 
diseases of the skin are idiopathic or exanthematous. 

Sarcoptic Mange 

This is a parasitic skin disease caused by the bur- 
rowing into the skin of the Sarcoptes squamiferous 
and is characterized by inflammation, pruritus, and 
loss of hair. The eruption at first resembles flea 
bites, but the patient's efforts to relieve the irritation 
by scratching may cause the whole area to become 
erythematous. Papules then make their appearance, 
later becoming vesicles that eventually burst, leav- 
ing little raw spots. The usual sites of this erup- 
tion are the head, bridge of the nose, base of the 
ears, eyebrows, the belly, around the elbows, root 
of tail, the paws, the inside of the legs, and some- 
times the genitals. It spreads rapidly and may in- 
volve the whole body in less than a month. In 
neglected cases the skin becomes greatly thickened, 
wrinkled, covered with scales and scabs, and ofter 
traversed by fissures. Warmth and exercise increase 
the itching. It is very contagious, and patients 
should be rigidly isolated. 

Treatment. — Isolate the patient and clip off the 
hair from the whole body. Wash thoroughly in 
warm water and green soap to remove dirt, scab, 

135 



136 CANINE MEDICINE AND SURGERY 

and so on, then dip in the following solution, brush- 
ing it in thoroughly with an old hairbrush : 

Sulphur lbs. ii 

Lime lbs. i 

Water cong. ii 

Boil this mixture until it turns a deep orange 
color and make up to five quarts, with water. Re- 
peat the treatment in ten days. In mild cases it is 
sufficient to clip the hair around the affected spot 
and apply the above solution, or in sensitive situa- 
tions like the eyelids or eyebrows, equal parts of 
balsam of Peru and olive oil make a most satisfac- 
tory substitute. Repeat the treatment every ten 
days until a cure is effected. 

Follicular Mange 

Follicular mange is one of the most serious skin 
diseases from which our patients suft'er, the parasite 
being so deeply situated that parasiticides have no 
permanent effect and bacterin treatment is eff'ective 
in only a few cases. 

Cause, — Follicular mange is caused by a parasite, 
the Demodex folliculorum, which gains access to the 
sebaceous glands and hair follicles and there multi- 
plies. These parasites produce the characteristic 
symptoms of the disease by the irritation they them- 
selves create and by opening the doors for the in- 
vasion of pyogenic organisms. 

Symptoms. — The disease exists in two forms, the 
squamous and the pustular. In the former the re- 
gions affected are usually around the eyes, lips, 
throat, breast, and legs, but it may extend to the 
whole body. The skin becomes inflamed and cov- 
ered with scabs and the hair falls out, leaving bald 
patches. By gently scraping the parts with a blunt 
knife and placing the debris so collected under the 
microscope the parasite can be easily discovered. 



DEMODECTIC MANGE 137 

This parasite is easily distinguished from that of 
sarcoptic mange in that the latter is shaped some- 
what like a horseshoe, while the former is elongated, 
has four pairs of legs and a segmented abdomen, 
and in shape somewhat resembles an oat grain. (For 
full description, see works on parasitology.) 

In the pustular form, pustules varying in size 
from a millet seed to the size of a pea are found 
studded all over the affected area. These pustules 
sometimes become confluent and larger areas of 
skin become necrotic. On pressu-re of one of these 
pustules, a sanguineous pus exudes which, if ex- 
amined under the microscope, reveals the presence 
of xiumerous demodecidse. As time goes on the skin 
becomes covered with scales and much thickened. 
Fissures and cracks make their appearance, become 
infected, and exude a bloody pus that cakes on the 
skin and gives the patient a most loathsome appear- 
ance. Irritation as a rule is not great, and some- 
times even entirely absent, but the skin is tender, 
and scratching or rubbing the aft'ected parts is re- 
sented by the patient. In addition to the visible 
lesions there is a characteristic mousy odor ema- 
nated from the patient that, once experienced, is 
unmistakable. 

Treatment. — This is most unsatisfactory, the usual 
parasiticides being practically useless. The only 
method at present that holds out any hope of per- 
manent relief is the bacterin treatment. 

The patient must first of all be thoroughly washed 
with green soap and a mild coal-tar antiseptic to re- 
move all accumulations of scales and discharge. 
Evacuate all pustules and give another antiseptic 
bath (kerosene emulsion is suitable). 

Every three to five days inject hypodermically a 
staphylobacterin. Dust the whole body with pre- 
pared chalk {creta preparata) often enough to keep 



138 CANINE MEDICINE AND SURGERY 

the affected parts well covered. . Keep evacuated all 
pustules that form, but use no further baths or 
antiseptic crashes. If the treatment is successful 
and pustule formation ceases, the remaining der- 
matitis can be relieved by inunction of Lassar's 
paste,* or of a paste composed of : 

Ac. salicylic 2 parts 

Amylum 24 parts 

Zinc oxid 24 parts 

Petrolatum alba 50 parts 

Ringworm and Favus 

Both of these ailments are caused by vegetable 
parasites of the genus hypomycetes or fungi. 

Favus is caused by the Achorion schonleinii, 
which, by attacking the skin and hair, causes de- 
struction of the latter and the formation of cup- 
like depressions and scab formation in the former. 
These scabs (scutula) are of a roundish shape, con- 
cave in the center, and of a yellowish color. When 
removed they leave a depression in the skin which 
is thin and discolored with blood. The hair in the 
affected portion of the skin falls out, leaving bare 
spots, and the irritation is considerable. 

Ringivorm is caused by another fungus — the Tri- 
chophyton tonsurans — which invades the hair with 
its mycelium, the spores as a rule being clumped 
round outside the hair. This invasion of the hair 
and its root produces inflammation of the follicles 
and renders the hair brittle, so that it breaks off. 
The clinical symptoms of ringworm are varying 
irritation, circular bald patches on the skin, slightly 
elevated at their circumferences and covered with 
dry, grayish-colored scabs. Upon close examina- 
tion a few stumps of hairs which have broken off 
are observed in these bald patches. If an affected 

*Lassar's paste consists of vaselin six ounces; zinc oxide and 
starch of each six drams and salicylic acid thirty grains. 



RINGWORM 139 

hair be pulled out with the forceps a white-gray 
fuzz is observed around its roots. If placed upon 
a slide, treated with a drop of potassium hydroxid, 
and placed under the microscope the spores can be 
seen ranged around or in the hair and the felt-work 
of the mycelium penetrating its substances. 

Both favus and ringworm are contagious to man 
and other animals, and every care should be used 
to avoid the spread of these diseases. 

Treatment. — Practically the same treatment is 
given for both conditions. In favus all loose hairs 
should be removed with the forceps and the scutula 
lifted off so as to expose the underlying skin. In 
ringworm all affected hairs must be pulled out and 
the healthy hair clipped away around the circum- 
ference of the affected area, as the disease spreads 
from the periphery. In both favus and ringworm, 
tincture of iodin should then be painted both on the 
affected portions of the skin and that immediately 
surrounding them. Treatment is often rather tedious, 
fresh patches developing as one is cured. Some- 
times, for some unexplained reason, iodin seems to 
be ineft'ectual to promote a cure, and in these cases 
the author has had most excellent results from giv- 
ing the parts an application of bichlorid of mercury, 
1-300, in alcohol. When the parts are dry follow 
with an ointment as follows : 

Ac. Salicylic 

Ac. benzoic, aa gr. xv 

Petrolatum alba oz. i 

Care should be exercised to burn all extracted 
hairs and scabs and to disinfect the hands after 
applying treatment in order to prevent infection. 
Patients should, of course, be isolated, and the ken- 
nels disinfected and bedding burned before other 
patients occupy them. 



140 caMIne medicine and surgery 

Parasitic Dermatitis 

The dog flea, Pulex serraticeps ; the dog louse, 
Trichodectes latus; ticks, Ixodes, and harvest bugs, 
Trombidii, often extensively infest our patients and 
are the cause of much irritation and a mild form of 
dermatitis, which is augmented by the patient's 
efforts to relieve the itching by scratching. If the 
superficial abrasions caused by the animal's claw 
become infected, very troublesome and sometimes 
extensive sores are produced. Both fleas and lice 
should be eliminated as quickly as possible, since 
they are not only a drain on the patient's constitu- 
tion but may be the intermediate hosts of the Taenia 
canina. 

Fleas are fairly easily gotten rid of by a thorough 
washing in a creolin solution. It must be remem- 
bered, however, that the female flea does not lay 
her eggs on the animal, but in cracks and crevices 
of the floor and sides of the kennel, and in bedding, 
dust, and filth, so that in addition to the treatment 
of the patient, his bedding, kennel, or sleeping place 
must also be thoroughly cleaned either with boiling 
water or a strong solution of creolin in order to 
destroy the eggs and larvae. If this latter precaution 
is omitted the patient will be reinfested in a very 
short time. 

Lice are much harder to eradicate than fleas, for 
although the adults are easily enough disposed of 
by bathing in creolin water or by applications of 
tincture of larkspur, yet the "nits," or eggs, which 
are attached to the hairs, are extremely resistant to 
the action of parasiticides on account of their kerati- 
nous covering. The patient should first of all be 
washed in a strong solution of sodium bicarbonate, 
which softens the nits, allowing the subsequent ap- 
plication of the chosen parasiticide to destroy the 



ERYTHEMA 141 

contained embryos. In addition, as many nits as 
possible should be removed by the' use of a fine- 
toothed comb. 

Ticks infest the dog and cause considerable irri- 
tation and obstinate sores if the invader is pulled ofif, 
as it invariably leaves its pinchers behind. The 
most effectual way to relieve the patient from ticks 
is to drop a few drops of gasoline onto each indi- 
vidual tick, which immediately lets go and can then 
be removed and destroyed. A ready way to remove 
ticks while camping or in the woods where gasoline 
is not available, is to make the tick let go by hold- 
ing the end of a lighted cigarette or cigar to its 
posterior extremity. 

Harvest hugs also infest dogs, and are the source of 
much irritation. They yield to the lime and sul- 
phur dip or to application of benzine or gasoline. 

The dermatitis resulting from the invasion of any 
of the above vermin is easily controlled by the appli- 
cation of mild antiseptic lotions or Lassar's paste. 
Infected sores should be disinfected with tincture of 
iodin and dressed with an antiseptic dusting powder. 

Erythema 

This disease consists of a hyperemia of the papillae 
and superficial layers of the skin. 

Cause. — Erythema occurs either independently or 
forms the introductory stage of other skin dis- 
eases. Its causes are mechanical, due to pressure, 
whipping (wheals), dipping dust, and friction; the 
result of chemical irritants, due to washing with 
crude soap, unduly strong antiseptics, insect bites, 
and decomposition of urine on the skin near the 
place of discharge during paralysis of the hind legs ; 
or thermal, the result of excessively high or low 
temperatures, burns and scalds of the first degree, 
or sunburn. 



142 CANINE MEDICINE AND SURGERY 

Symptoms. — More or less redness, diffuse or local- 
ized, which can be made to disappear temporarily 
by pressure of the finger, is an indication of ery- 
thema. This redness is often accompanied by in- 
tense pruritus. 

Treatment. — The cause, if possible, should be re- 
moved and the affected parts soothed with appli- 
cations of liquor plumbi subacetatis, Lassar's paste, 
or oxid of zinc ointment. Burns and scalds should 
be dressed with a saturated aqueous solution of 
picric acid, and intense itching may speedily be re- 
lieved by painting on a six-per-cent solution of silver 
nitrate. 

Eczema 

Eczema is a dermatitis, manifesting itself in vari- 
ous stages of development and intensity. The stages 
which a typical eczema goes through are as follows, 
but it must be remembered that the disease may 
terminate or become chronic in either one of them, 
also that the clinical picture may be quite materially 
altered in appearance by the patient's rubbing, 
scratching, or biting to relieve the pruritis. 

1. The erythematous stage, which consists of 
hyperemia of the skin, with slight exudation and in- 
creased proliferation of the epidermis, which later 
becomes exfoliated as scales or scabs. 

2. The papular stage, characterized by the forma- 
tion of small red papules, which are caused by small- 
celled infiltration and serous saturation of the indi- 
vidual papillae of the dermis. 

3. The vesicular stage, which develops when the 
serous saturation is so extensive as to rupture the 
cells of the rete mii(<>fum, the fluid then penetrat- 
ing as near to the surtace as the stratum corneuiu. 

4. The moist or weeping stage, which results 



ECZEMA 143 

from the rupture of the vesicles either spontaneously 
or from traumatic causes. 

5. The pustular stage, which results from the 
transformation into pus of vesicles filled with serum. 
These pustules often become confluent, producing 
large suppurating areas. 

6. The scaly stage, which results from the drying 
up of the exuded matter and the desquamation of 
the dead epidermal cells. 

As before stated, it is by no means necessary that 
the disease pass through all the above stages. An 
early stage may pass directly into the last, or the 
eczema may long remain persistently in the same 
stage. 

Causes. — Eczema is usually set up as the direct 
result of some external irritant acting upon the 
skin, such as dust, mud, fleas, lice, too frequent 
bathing, and the use of soap. Injurious foods and 
digestive disorders with faulty elimination no doubt 
act as predisposing causes, but the disease must be 
attributed to direct local irritation. 

Symptoms. — In the initial stage, which very often 
passes unobserved, bright red spots appear, sur- 
rounded by a hyperemic area. These spots rapidly 
run together, the affected skin becoming spongy, 
turgescent, and of a high temperature. The hair 
in the affected area stands erect, and the skin is 
tender and irritable. Owing to the patient's efforts 
to relieve the pruritis, the pustular and scaly stage 
may immediately be entered upon, but if the disease 
runs its regular course, small blisters develop from 
the pimples. By confluence of these vesicles moist 
and reddened areas of skin are formed from which 
the hair falls out. These areas are covered with a 
serous, sero-fibrinous, or even purulent exudate, and 
are exceedingly sensitive to the touch and show a 
tendency to spread. 



144 CANINE MEDICINE AND SURGERY 

Frequently the vesicles change into pustules, pus- 
tular eczema then being the result. The blisters en- 
large and their contents grow dull and become pur- 
ulent. The pustule may remain isolated, spread in 
groups, or run together, producing patches of vari- 
ous size. The hairs then become erect, stick to 
each other, and are glued together by the exudate 
into stiflf tufts, which become felted and are easily 
pulled out or fall out spontaneously. The skin 
thus laid bare is found to be thickened, exquisitely 
tender, and covered with a yellowish, creamy, 
sticky pus. 

Healing follows by the drying up of the purulent 
discharge into scabs and crusts, under which sup- 
puration persists for some time. Similar localized 
purulent inflammations of the skin occur, without 
any preceding stages, as a direct result of mechani- 
cal, chemical, or thermal irritation. 

Eczema may in all its stages become chronic. 
The most important factor here is to prevent the 
patient from rubbing the afifected areas. 

The changes produced in the skin by chronic 
eczema consist in persistent hyperemia, higher tem- 
perature, and thickening. The skin gradually be- 
comes hard and dry and loses its elasticity. The 
hairs become thin and stray (compression and 
atrophy of the hair papillae and their blood supply). 

The condition of the patient in ordinary cases 
remains unaltered except for restlessness and often 
extreme thirst. In cases of long duration, however, 
the continued irritation in time produces emaciation 
and, in weakly subjects, results in cachexia and 
death. Acute eczema may last for from one to three 
weeks, while the chronic form of the disease persists 
for months or years and is frequently incurable. 

Treatment. The treatment varies both according 
to stage and individuality. The main obstacle to 



ECZEMA 145 

success is the persistent itching and the patient's 
efforts to relieve it. If possible, the cause must 
be removed, and in all cases the alimentary tract 
should be cleaned out by a brisk saline purgative 
and kept clean by the daily administration of five 
grains of the sulphocarbolates of zinc, calcium, and 
sodium in water three times a day. Contrary to 
popular opinion, diet exercises little influence either 
on the production or course of the disease, but 
often a complete change of diet gives wonderful 
results. Bathing and the use of soaps are abso- 
lutely to be avoided during an attack and used only 
with great discretion upon recovery, or a relapse 
may occur. 

In the earlier stages of eczema erythematous, 
papular, and vesicular, soothing and emollient ap- 
plications are to be employed. Liquor plumbi sub- 
acetatis applied to the affected parts, followed by 
a dressing of zinc oxid ointment or Lassar's paste, 
is most efficient. 

In the later stages (weeping or pustular) the 
matted hairs should be clipped oft" and the parts 
cleaned with hydrogen peroxid and dried with ab- 
sorbent cotton swabs. The affected parts should 
then be painted with a six-per-cent aqueous solu- 
tion of silver nitrate and kept dusted with a desic- 
cant dusting powder such as ten parts of aristol, 
formidin, or boric acid, ten parts of starch, and 
one part of tannic acid. 

For chronic eczema a more stimulant line of 
treatment is necessary. The hair should first all be 
clipped off and the skin dressed with any of the fol- 
lowing dressings which are all effective, although the 
first mentioned is most excellent : Four parts of oil 
of tar, forty parts olive oil, one part iodin glycerin ; 
thirty grains chrysarobin to one ounce vaselin, or 
sulphur ointment B. P. 



146 CANINE MEDICINE AND SURGERY 

Internally, administer five to ten drops of Fowler's 
solution once a day. 

Urticaria 

Urticaria is manifested by sharply defined, flat, 
raised swellings of the skin, the result of quickly 
occurring serous transudation in the papillae of the 
dermis. The cause of this transudation of fluid is 
the sudden dilatation of the capillaries, consequent 
on undue stimulation of the vasomotor nerves. 

This affection of the vasomotor nerves may be 
due to external irritation or it may be of internal 
origin. The external irritants may be bites of 
insects, stinging nettles (Urtica urens), or the hairs 
of caterpillars. 

The internal causes of urticaria are due to cer- 
tain kinds of foods which, owing to individual sus- 
ceptibility, act as toxines, or to the absorption into 
the blood stream of toxic matters from the alimen- 
tary canal (fecal toxemia). 

The pomphi are sudden in their appearance and 
frequently run together, producing large edematous 
areas. The treatment consists in warm fomenta- 
tions and the administration of a smart saline 
purge. 

Alopecia 

Falling out of the hair occurs as an independent 
condition and may affect the whole body (alopecia 
celsi), or it may be confined to loss of hair from 
small areas (alopecia areata). It is due to a 
trophoneurosis of the cutaneous nerves, which 
causes atrophy of the hair roots. The conditions 
which lead to this neurosis are pregnancy, starva- 
tion, suckling, spoiled food, and debility. As a rule, 
in alopecia celsi the hair grows in again, but in alo- 
pecia areata the condition often remains permanent 
and quite resistant to treatment. 



ACNE 147 

Treatment. — Stimulating liniments applied with 
friction to the skin, such as one part tincture can- 
tharides, five parts spiritus vini rectificatus or lini- 
mentum saponis and spiritus camphorse equal parts, 
or liquor ammonii fortior one-half dram and spiritus 
rectificatus, eight ounces. 

Acne 

Acne is a suppurative inflammation of the folli- 
cles of the skin arising from the accumulation and 
decomposition of the sebum secreted by the seba- 
ceous glands, and the invasion of pyogenic or- 
ganisma. 

The disease is generally localized upon the skin 
of the nose between the anterior nares and the 
forehead. 

Symptoms. — At first, signs of superficial inflam- 
mation are evident, then as the deeper follicles be- 
come infected the skin appears thickened and upon 
pressure discharges at various points a bloody, pur- 
ulent matter. Nodules the size of a pea are also 
present, which show purulent centers. By conflu- 
ence of the acne pustules and infection of the hair 
follicles large abscesses are formed, portions of the 
skin sometimes becoming even necrotic. In rare 
cases acne is found on the forehead, trunk, and ex- 
tremities, in which case the prognosis is very grave. 

Treatment. — Incision and free evacuation of the 
acne pustules and abscesses, and disinfection with 
tincture of iodin or Lugol's solution, are advised. 
In persistent cases an autogenic bacterin should be 
prepared and injected hypodermically every five 
days. 



SECTION XIX 

INFECTIOUS CONSTITUTIONAL DISEASES 
Distemper 

THIS is the most widespread, the most common, 
the most fatal, and with the exception of rabies 
the most dreaded malady of dogs. When first dis- 
covered in France, from which country it was im- 
ported into Great Britain, it was and is still named 
distemper, yet that name seems imhappily chosen 
as being too indefinite for correct application to a 
disease marked by such varying phases. Distemper 
is also known as "dog ill" in some parts of Eng- 
land, and the Scotch term it "the snifters." This 
latter term, although unscientific, certainly graphi- 
cally conveys to the mind one important character- 
istic of the disease, namely, the snifting noise — 
half-cough, half-sneeze — made by the dog in his 
efforts to get rid of the exudate which accumulates 
in the upper air passages ; but "snifting" is a term 
too limited to adequately describe a disease which 
has well been called the "scourge of the kennel," 
and which assumes so many forms and complica- 
tions. 

Etiology. — Until quite recently the causative 
agent of this disease was simply a ijiatter of specu- 
lation, many theories being advanced as to the etio- 
logical factor. The microorganism now definitely 
determined as the sole cause of distemper is the 
Bacillus bronchisepticus*, discovered and isolated in 
pure culture by Dr. N. S. Ferry. Although respon- 
sible for the primary symptoms of the disease, the 
Bacillus bronchisepticus is by no means responsible 



♦Many able observers have been unaljle to verify the findings of 
Perry, and the causative factor in canine distemper may be said 
to be unsettled in tlie minds of many bacteriologists, not a few of 
whom believe the agent to be a protozoan. 

148 



DISTEMPER 149 

for the complications which generally ensue during 
the course of the malady. There are always closely 
associated with it the various strains of Staphylo- 
cocci and Streptococci, and it is the effect of their 
combined toxins that gives us the clinical picture 
which an animal presents when suffering from dis- 
temper. Among the predisposing causes of dis- 
temper may be mentioned youth, unhygienic sur- 
roundings, in-breeding, in fact, any circumstance 
which tends to lower the animal's vitality and its 
powers of resistance to disease or unfavorable con- 
ditions. 

Symptoms. — The symptoms of distemper vary 
considerably according to the particular local com- 
plications which are developed ; they are also de- 
pendent upon the severity of the attack, the powers 
of resistance of the patient, the rapidity with which 
the disease progresses and the treatment the pa- 
tient receives. As a rule, the first observable symp- 
toms are pronounced lassitude and dullness, a great 
disinclination to play or exercise, a decided prefer- 
ence for warmth, the dog creeping into the warm- 
est corner or crouching before the fire, and a gen- 
eral languor that appears to benumb the dog's ener- 
gies ; so that the hitherto lively dog, instead of 
jumping with delight at his master's call, merely 
replies with a spiritless wag of his tail and a dis- 
mal, woe-begone look. , Loss of appetite is an in- 
variable symptom and feverishness ensues, as 
shown by the hot, dry nose, rigors, and by the 
clinical thermometer; considerable thirst is present; 
the bowels are generally deranged, sometimes re- 
laxed, sometimes constipated ; the urine is scanty 
and high-colored; the coat is usually rough 
and staring; retching and vomiting often oc- 
cur; there is a thin, watery discharge from the 
nose and eyes, and a hyperemic condition of the 



150 CANINE MEDICINE AND SURGERY 

conjunctivae ; and the eyes appear unusually sensi- 
tive to light. 

A short, dry, husky cough and sneezing occur, 
especially when the animal is brought into the open 
air. The discharge from the eyes and nose gradu- 
ally becomes more purulent, sticking the nostrils 
and eyelids together, causing the patient much dis- 
comfort and inconvenience and interfering with 
respiration, and resulting in constant efforts to clear 
the nostrils which produce that peculiar noise that 
has earned for the disease the popular name above 
mentioned. In many cases the eyes are seriously 
affected. 

A small bluish-white opacity may be observed 
which gradually widens and deepens until an ulcer 
is formed. This ulcer, which, by perforating the an- 
terior layers of the cornea, may cause the con- 
dition known as staphyloma or may even allow the 
aqueous humor of the eye to escape. Such cases, 
although of alarming appearance, usually do 
well under appropriate treatment, although in some 
cases of extreme severity some slight opacity of the 
cornea may remain. As the progress of the disease 
advances, special symptoms present themselves, de- 
pending upon what organ or organs are chiefly 
involved. However, a constant and unvarying 
symptom in all cases of distemper, irrespective of 
local complications, is rapid emaciation and loss of 
strength. 

In cases where the respiratory tract is chiefly 
involved the symptoms of bronchopneumonia pre- 
dominate. When the digestive tract is the subject 
of serious invasion, digestive disturbances are em- 
phasized and there is vomiting, profuse watery and 
offensive diarrhea, and in many instances an icterus. 

When the central nervous system is involved 



DISTEMPER 151 

symptoms of cerebral congestion, accompanied by 
convulsions and sometimes by attacks of mania 
closely resembling those of rabies, make their ap- 
pearance. Again the patient may become partially 
or even completely paralyzed, or it may develop 
the persistent clonic convulsion of some group or 
groups of muscles, known as chorea. 

In distemper the skin, especially that inside the 
thighs, on the chest, and on the belly, is often the 
seat of a pustular eruption (the exanthema of dis- 
temper). These pustules discharge their contents, 
dry up, and form scabs. The scabs later on fall 
off, leaving small depigmented areas. 

The significance of the appearance of this exan- 
thema is still a debated question among practition- 
ers, some contending that it foreshadows a fatal 
termination, others that its appearance is a favor- 
able symptom. The author's experience is that it 
is merely a manifestation of the disease and has no 
significance either one way or the other. 

Another prominent symptom in distemper is the 
characteristic and exceedingly offensive odor ema- 
nating from the patient's exhalations and from the 
skin, the latter also having a peculiar greasy feel 
to the touch which can hardly be mistaken when 
once experienced. 

Treatment. — The therapeutic indications for dis- 
temper vary with the particular complications the 
case presents. " In other words, symptoms must be 
treated as they arise, but the whole rationale of 
treatment may be summed up by saying that the 
patient's powers of resistance must be raised to 
resist the invading organisms, and free elimination 
must be established to carry off both the microbic 
toxins and those .toxins produced by the normal 
flora of the intestinal canal, which in disease are 



152 CANINE MEDICINE AND SURGERY 

absorbed into the system because of imperfect 
elimination and perverted metabolism. Thus we 
have to deal not only with the toxemia produced 
by the primary invading organism, but also with 
the condition known as autointoxication or autj- 
toxemia. 

Elimination may be secured by medicines caus- 
ing free evacuations of the bowels and by those 
stimulating the free excretion of urine. To obtain 
the former, a dose of calomel should be given, 
preferably in repeated small doses to effect ; the 
latter may be attained by appropriate doses of such 
diuretic medicines as spirits of nitrous ether, potas- 
sium nitrate, potassium acetate, or potassium 
citrate. 

In- addition to this cleaning-out process, the flora 
of the alimentary tract must be kept under control 
by the use of intestinal antiseptics, such as calcium 
creosote, the sulphocarbolates of zinc, calcium, and 
sodium advantageously combined with a bismuth 
salt, acetozone, (fifteen grains to the quart of water 
and given ad libitum in the drinking water), creo- 
sote, or salol in enteric-coated pills or capsules. 

To raise the patient's powers of resistance a 
bacterin composed of Bacillus bronchisepticus com- 
bined with Staphylococcus, aureus and albus, must 
be administered hypodermically every three days in 
ascending doses. The action of the bacterin treat- 
ment is much increased, especially if the patient 
has not come under observation until the disease 
is well advanced, if a simultaneous hypodermic in- 
jection of nuclein is administered. The respiratory 
complications must be treated as they arise, under 
the directions given previously for handling respira- 
tory diseases (see pp. 12-30). 



DISTEMPER ' 153 

A useful combination for general routine of cases 
is as follows: 

IJ Glycoheroin oz. iiss 

. Nuclein solution oz. iiss 

Potassium citrate dr. ii 

Aquas q. s oz. x 

M. Sig. — Give four drams twice daily. 

Gastrointestinal complications are treated with the 
usual ag-ents for the control of vomiting, diarrhea, 
and intestinal fermentation. 

The nervous symptoms should be controlled by 
ice packs applied to the head, if cerebral congestion 
occurs, followed by the internal administration of 
bromids, preferably strontium bromid in five tc 
twenty-grain doses, since this salt is less liable to 
create gastric disturbance than is potassium bromid 
Chorea* is best treated by the prolonged adminis- 
tration of Donovan's solutionf, and paralysis is most 
successfully combated by strychnin and electrical 
massage. The exanthema requires only the appli- 
cation of an antiseptic wash, such as chinosol (1- 
1000). 

The eyes require treatment from the onset of the 
disaese. All discharge must be wiped away with 
cotton-wool swabs soaked in a warm solution of 
boracic acid and a few drops of a five-per-cent solu- 
tion of protargol dropped into the conjunctival sack. 
When ulcerations occur a ten-per-cent solution 
of protargol should be used, or the ulcers should 
be touched lightly with a stick of silver nitrate. 
Any opacity left may generally be removed by the 



♦Recently considerable publicity Iiae been given to tlie hypo- 
dermic u.se of a normal brain (rabbit) emulsion in the treatment 
of chronic cases of chorea. Its value in this connection has not 
yet been determined. 



tDonovan's solution consists of arsenic iodid and mercuric 
iodid, of each one part, in 100 parts of distilled water. 



154 CANINE MEDICINE AND SURGERY 

daily application of a one-per-cent yellow oxid of 
mercury ointment. 

Nursing and Diet. — Good nursing and an appro- 
priate diet form one of the most essential features 
of the successful treatment of distemper. Without 
them the most scientific and rational treatment is 
seriously handicapped, if not entirely useless. 

It must bo remembered that, even with the bac- 
terin tre^pent, distemper will run its course either 
to a favOTable or fatal termination, and that there- 
fore no effort must be spared to sustain the patient's 
vitality during the progress of the disease. 

Good nursing consists in seeing that the patient 
is kept in sanitary surroundings ; that he has be- 
fore him at all times a plentiful supply of clean, 
cold water; that his eyes and nose are kept clear 
of discharge and that his teeth and mouth are 
cleaned at least once daily with some antiseptic 
wash. This latter point, although generally over- 
looked, has a most important bearing on the amount 
of nourishment the patient can be coaxed to take. 
A dirty, furred-up mouth and unclean teeth are the 
cause, in a great many instances, of the animal's 
refusal of all nourishment. It is also the nurse's 
duty to administer the prescribed medicines and 
diet, as directed by the attending veterinarian. 

The diet for a dog suffering from distemper must 
be appetizing, easily digested, and easily assimilated. 
The patient should be fed four or five times a day, 
small quantities at a time. In the case of a severe 
attack, with great prostration and weakness, it is 
necessary to compel the patient to take nourishment 
by drenching him with beef tea, raw eggs, milk, 
and so on. Any of these liquid foods may in these 
cases be advantageously combined with stimulants, 
such as small quantities of whisky, brandy, or port 
wine. 



RABIES 155 

The diet should consist of raw meat minced fine, 
or, if the patient prefers it, of cooked meat, milk, 
eg-gs, and beef tea. Great care must be taken not 
to upset the patient's digestive system, and no in- 
digestible articles of diet should be allowed. 

When convalescence sets in, as shown by the im- 
proved appetite, subsidence of symptoms, and raised 
spirits, a good tonic must be administered (triple 
arsenates). ^ 

Prophylaxis. — Owing to the extreme contagious- 
ness of the disease, great care must be exercised to 
prevent its spreading. The patient should be isolated, 
all articles coming in contact with him, such as dishes 
and water troughs, should be sterilized by boiling 
immediately after use. All brushes, bedding, 
sponges, swabs and other articles should be burned, 
and upon recovery the premises must be thoroughly 
disinfected. The attendant should sterilize ther- 
mometers, pill guns, and medicine spoons before 
using them again ; he should wear a gown while 
handling the patient, and should disinfect his hands 
and boots before proceeding to the next case. It 
is advisable to immunize all dogs exposed to the 
infection with a prophylactic dose of distemper bac- 
terin. 

Rabies 

Rabies is a true infective disease and is transmit- 
ted solely by inoculation, generally by the bite of 
an affected animal. Noguchi, of the Rockefeller Insti- 
tute, and Zell, of Chicago, simultaneously and inde- 
pendently have recently isolated and cultivated the 
cause of rabies, which appears to be a protozoan, 
present in the tissues of the central nervous system, 
saliva, and urine. The virus is fixed and endo- 
genous, that is to say, the animal body is absolutely 
necessary for its natural development. The period 



156 CANINE MEDICINE AND SURGERY 

of incubation varies from three to six weeks or 
long-er, with an average of twenty-five days. 

Symptoms. — The clinical appearance of rabies oc- 
curs in two forms, namely, furious rabies and dumb 
rabies. The two are only different forms of one 
and the same disease, not two different diseases as 
was formerly supposed. It must be understood, 
however, that there are many intermediate forms 
between these two varieties, which often merge so 
closely into each other that a distinction is impos- 
sible. Rabies runs an acute and invariably fatal* 
course in from two to ten days. 

Furious Rabies 

There are three stages recognized in furious ra- 
bies, — the premonitory stage, the maniacal stage, 
and the paralytic stage. 

The premonitory stage lasts on an average from 
twelve to forty-eight hours and is characterized by 
an alteration in the behavior and disposition of 
the patient. The animal becomes either morose and 
sullen, furtive and irritable, or shows just the op- 
posite characteristics — an increased alTection and 
desire for its master's notice. Restlessness and 
nervousness, and a capricious and perverted appe- 
tite, are well-marked symptoms of the disease. In 
some cases hyperesthesia in the region of the site 
of inoculation causes the patient to bite at the 
seat of injury. There is a tendency to gnaw and 
tear up whatever comes across his way, and he 
sometimes swallows foreign objects, such as stones, 
earth, grass, rags, pieces of wood, and even excre- 
ment. In other cases the patient continually licks 
his genital organs and shows sexual excitement. 



*It i.s believed by some competent authorities that mild cases 
of rabies occur which are not ordinarily recognized and from 
which the animal recovers. It is believed that the disease is often 
spread by these mild unrecogni^ced cases. 



RABIES 157 

In this stage is noticed slight difficulty in swallow- 
ing, inclination to vomit, dyspnea, and symptoms of 
choking. Constipation is usually present. 

The maniacal stage lasts three or four days and 
is characterized by attacks of mania and convul- 
sions, with remissions. The patient evinces an over- 
whelming desire to run away from home, tearing 
down doors and kennels or breaking his chain in 
order to effect his escape. 

At first the animal shows only a slight tendency 
to bite, running along aimlessly, sometimes for 
long distances, but later on it begins snapping at 
imaginary objects, or at other animals or people 
that are directly in its way, until finally, losing- 
all control and impelled by some uncontrollable 
impulse, it savagely and aggressively attacks every- 
thing in sight. In some cases the patient may bite 
and tear its own body, being apparently insensible 
to pain. A prominent symptom in this stage is 
the alteration in the voice, which manifests itself 
as a peculiarly hoarse, howling bark, the first notes 
of which are prolonged into a high-pitched, long- 
drawn-out howl. 

In the paralytic stage the patient is much emaci- 
ated. The eyes are deeply sunken, staring, and 
glassy, and there is usually external strabismus of 
one eye. The patient now becomes gradually para- 
lyzed, swallowing becomes impossible, and the 
saliva runs out of the mouth in ropy masses. In 
time comes paralysis of the lower jaw, which hangs 
down, allowing the tongue to protrude. This con- 
dition is followed by paralysis of the hind quarters 
which manifests itself in staggering, stumbling, and 
by increased bodily weakness. The muscles of the 
tail, rectum, and bladder become paralyzed, and 
symptoms of great depression are alternated with 
paroxysms of excitement that gradually become 



158 CANINE MEDICINE AND SURGERY 

rarer and rarer, but which, throughout the course 
of the disease, are increased in violence by the 
sight of another dog. Finally the paralytic condi- 
tion becomes complete and the animal's sufferings 
are ended by death. 

Dumb Rabies 

Dumb rabies is distinguished from the furious 
type by the early onset of the paralytic symptoms 
and the absence of the desire to bite unless greatly 
aggravated. The patient early becomes dull and 
listless and often appears to have some slight dif- 
ficulty in swallowing; anorexia is always present. 
It is in cases of dumb rabies that the veterinarian 
needs to use much caution when called upon to ex- 
amine an animal that is supposed to have a "bone 
in its throat." The paralysis of the lower jaw takes 
place quite early in the course of the disease and 
is rapidly followed by the general paralytic con- 
dition described above, death usually taking place 
about the third day. 

Treatment. — The disease being quite unamenable 
to therapeutic measures, any treatment is useless* 
in either the furious or the dumb forms, but val- 
uable animals may be saved before symptoms have 
developed if given the Pasteur treatment as soon 
as possible after being bitten by a rabid animal. 

Tetanus 

Tetanus is a specific infective disease, character- 
ized by tonic muscular spasms and caused by the 
Bacillus tetani. The spores of the Bacillus tetani 
are ubiquitous and gain entrance to the animal's 

♦Quite lecently several recoveries from rabies, brouglit about 
by the hypodermic use of quinln or quinin and urea hydrochlorid, 
have been reported by doctors of human medicine; iiowever, in 
inoculated cases these drugs have apparently had no influence on 
the course of rabies. A serum treatment (Zell) for rabies is being 
investigated at the present time. 



TETANUS 159 

system through wounds of the skin, however slight. 
The anaerobic properties of this bacillus make punc- 
tured and penetrating wounds the most favorable 
environment for its development. Suppurating 
wounds are also favorable to the development of 
the tetanus bacillus on account of the oxygen being 
used up by the pyogenic organisms, so that the 
deeper portions of the wound may be devoid of oxy- 
gen, thus allowing anaerobic organisms to develop. 
The organisms remain at the site of inoculation, the 
symptoms being produced by the action of their 
katabolic products or toxins on the nerve centers. 
Tetanus is unusual in dogs, this animal being 
rather less susceptible to the disease than is man 
and far less susceptible than the horse. 

Symptoms.— The general symptoms of tetanus 
are a greatly increased irritability of nervous reflex 
and tonic spasms of the various muscular groups. 
Trismus, or spasms of the masticatory muscles, oc- 
curs, causing the jaws to be firmly held together, 
hence the popular name of "lockjaw." The recti 
occulovum, when affected by spasm, cause the eyes 
to retract within their orbits and the membrana 
nictitans to protrude over the eyeballs. The whole 
body becomes rigid ; the extremities stiiT and stilt- 
like, the neck outstretched, and the tail elevated. 
Breathing is interfered with by the spasm of the 
inspiratory muscles. 

Depending upon which group of muscles is 
mainly affected, the patient's body assumes various 
positions when the spasms are present. The head 
and tail may be elevated and the back depressed; 
the back may be arched and the abdomen tucked 
up; or the body may be curved laterally. The tem- 
perature is at first only moderately elevated, but 
in cases approaching a fatal termination it may 



160 CANINE MEDICINE AND SURGERY 

reach 108 to 110 degrees Fahrenheit and continue 
to rise for some time after death. 

The prognosis should be guarded. As a rule it 
is slightly more favorable in the dog than in the 
horse. 

Treatment. — Good nursing and the avoidance of 
all excitement and noise are essential. The patient 
should be placed in a darkened room and kept ab- 
solutely quiet, as on account of the extreme irrita- 
bility of the nervous reflexes the slightest sound or 
movement may induce or aggravate the spasms. 

Nerve sedatives are the drugs indicated, in order 
to endeavor to control the spasms, the most valu- 
able being gelsemium and lobelia. In exceptionally 
acute cases chloroform combined with H-M-C in 
full doses must be used to induce complete anes- 
thesia in order to relax the patient. It must be 
remembered that to produce the desired effect te- 
tanus patients require doses far in excess of those 
usually administered, and that these drugs may be 
pushed with safety. Elimination per anum and 
through the kidneys must be provided for, and 
enemas of predigested milk or beef given to sustain 
life, if the patient is unable to eat. 

Tetanus antitoxin is useless as a curative, but 
as a prophylactic is of undoubted benefit if ad- 
ministered before the appearance of symptoms. 

Anthrax 

Anthrax is an infective disease caused by the 
Bacillus anthracis. Young dogs are extremely sus- 
ceptible to anthrax, but mature animals appear to 
develop a comparative immunity. Eating meat con- 
taining anthrax germs is the usual cause of the 
disease in the dog. On this account the animal 
ordinarily suffers from the intestinal form of the 



TUBERCULOSIS 161 

disease and from local anthrax of the mouth and 
pharynx. 

It must be remembered that the blood of an in- 
fected animal is the medium of infection and also 
that while the bacilli themselves are comparatively 
easily destroyed, that the spores are extremely re- 
sistant to the action of disinfectants. The gastric 
juice has no effect upon the spores of anthrax, 
although it is bactericidal for the bacilli themselves. 

Symptoms. — Suddenness of attack, high fever, 
dyspnea, violent intestinal disturbances, hemorrhages 
from all the natural openings of the body, the local 
manifestations in the mouth and pharynx — saliva- 
tion, the presence of vesicles on the mucous mem- 
brane, swelling of the throat, cyanosis, are all 
indicative of this disease. The diagnosis is com- 
pleted by the microscopical examination of the blood 
and the identification of the Bacillus anthracis. 

Treatment. — Needless to say, suspected cases 
should be handled with extreme caution, as the 
disease is communicable to other animals and man. 
All blood and discharges should be carefully dis- 
infected and the carcasses should be cremated. At- 
tempts to cure the patient are futile. 

Tuberculosis 

Tuberculosis is not a common disease of the 
dog, but cases do occur and such can nearly always 
be traced to infection from mankind. It has been 
amply proved that the patient becomes infected by 
inhaling the dust from a room inhabited by a tu- 
berculous person, or by licking up tuberculous spu- 
tum or from eating food from the plate of a person 
aff'ected with tuberculosis. 

Symptoms. — Usually the disease assumes the as- 
pect of a chronic pneumonia or a chronic bronchial 



162 CANINE MEDICINE AND SURGERY 

catarrh, quite unyielding to treatment. The tem- 
perature is fluctuating, there usually being a rise 
towards night. There is often weakness and a 
rapid, progressive emaciation. Auscultation reveals 
areas of dullness, the presence of cavities, rales, 
suppressed respiratory murmur and so on. 

Diagnosis is assisted by the history of the case 
and a knowledge of the owner's state of health. 
It may be confirmed except in advanced cases by 
the tuberculin test. 

Treatment. — Owing to the danger to human be- 
ings, treatment should not be attempted. The pa- 
tient should be sent to the happy hunting grounds 
immediately. 

Granuloma 

This is a disease of true infection, a venereal dis- 
ease of dogs, affecting chiefly the mucous mem- 
brane of the vagina and of the penis and prepuce. 
It is transmissible by coition and by inoculation. 

Cause. — The causative agent is unidentified as 
yet. 

Symptoms in the Female. — Although the lesions 
are usually confined to the genital organs, other 
parts of the body may become afifected in conjunc- 
tion or independently. The lesions are generally 
found on the skin of the neck, throat, back, groin, 
abdomen and limbs. 

Metastatic growths are also often found in the 
abdominal and mesenteric lymphatic glands, kid- 
neys, spleen, liver and lungs. 

In the genital organs of the bitch the lesion gen- 
erally begins as a circumscribed swelling of the 
mucous membrane, deep red in color and by a grad- 
ual elevation of the tissue and develops into round 
nodular sessile tumors, these become lobulated, pre- 
, senting a warty and cauliflower-like appearance. 



INFECTIOUS GRANULOMA 163 

These growths are friable and bleed freely upon the 
slightest manipulation. 

They are most commonly situated in close prox- 
imity to the urethral opening. The presence of 
these infective venereal tumors is usually unsus- 
pected until a sanious, muco-purulent discharge is 
noticed at the vulva, Avhen an examination reveals 
their presence. 

In severe cases the whole vagina may become 
blocked up, rendering coition painful and parturition 
impossible. After about three months retrograde 
changes take place in the tumors which break down 
and disappear but invariably leave the vaginal wall 
inelastic by reason of cicatricial contraction, so that 
if numerous parturition is attended with grave dif- 
ficulties. 

Treatment. — The growths should be removed by 
dissecting them off the vaginal walls, their bases 
freely curretted and painted with tincture of iodine. 
Hemorrhage is easily controlled by packing the 
vagina with aseptic gauze. 

Symptoms in the Male. — Hemorrhage after co- 
ition, refusal to serve and sometimes difficulty in 
urination (if the growth involves the urethral open- 
ing) should lead to an examination for venereal 
warts. Exposing the penis by drawing back the 
prepuce of course reveals the condition. 

In the male the infective tumors, in the early 
stages of the affection, appear as small yellowish- 
white raised patches about the size of a mustard 
seed. Later on the growths take on the character- 
istic cauliflower-like appearance and bleed readily 
when touched. They may be situated at the ex- 
treme end of the penis, upon the sides or at its 
base. 

Treatment. — Secure the patient in the dorsal po- 



164 CANINE MEDICINE AND SURGERY 

sition and then fill i)repuce with a five per cent 
solution of cocaine. After waiting ten minutes to 
allow the parts to become properly anesthetized, 
expose the penis, pick up the growths with rat-tooth 
forceps and snip them off with sharp scissors, cut- 
ting well into the surrounding healthy tissue. The 
resulting wound should be treated antiseptically 
and, if extensive, sutured with fine silk (No. 00). 



SECTION XX 



INTERNAL PARASITES AND PARASITISMS 

CONTRARY to the popular belief, intestinal 
parasites, unless the infestation is particularly 
heavy, do not cause any very serious constitutional 
disturbances. How^ever, large numbers of parasites, 
especially in puppies, may give rise to alarming 
symptoms and in some instances even cause death. 
Intestinal parasites are detrimental to their host 
by reason of the irritation they produce, their in- 
terference with the digestive process, the deleterious 
effect of their waste products, the abstraction of 
blood, or by mechanical obstruction. We may, 
therefore, look for a definite train of symptoms 
when the infestation is heavy. 

The general symptoms of parasitism are a general 
unthrifty condition of the patient — a rough, dry 
coat, appetite variable but usually voracious, anemia, 
gradual emaciation and alternate constipation and 
diarrhea. Convulsions are common and in certain 
special cases there is bleeding from the nose. Pru- 
ritus ani is well marked in cases where the parasites 
inhabit the rectum. The diagnosis, however, is 
positive only when the parasites or their ova are 
detected in the feces. Notwithstanding the com- 
parative harmlessness of parasitism to the patient 
itself, every means should be employed to rid him 
of these pests and to destroy their ova and thus 
prevent their reproduction, on account of the danger 
from some of them to both man and other animals. 
Of these Taenia echinococcus and Taenia ccenurus 
are examples producing respectively hydatid disease 

165 



166 CANINE MEDICINE AND SURGERY 

in man and "gid" in sheep. Only brief reference to 
the morphology and life history is given here, the 
student being referred to the standard works on 
parasitology for more detailed information. 

Spiroptera Sanguinolenta 

This parasite is a small, round worm that in- 
habits the walls of the esophagus and stomach. The 
intermediate host is the Blatta orientalis. This 
nematode worm is readily recognized by its blood- 
red color, and in addition to its normal habitat as 
stated above, it may be found in the aorta, lungs, 
and lymphatic glands. Its presence in the esophagus 
and stomach forms tumors consisting of indurated 
tissues in which there are chambers containing the 
rolled-up worms. 

Symptoms. — Repeated vomiting and rapid emacia- 
tion give evidence of infestation by this parasite. 
Sometimes, too, there is rabiform convulsions. 

Ascaris Marginata 

The Ascaris marginata is a nematode worm, the 
male from five to ten centimeters long, the female 
from nine to twelve centimeters long. In color it is 
white or reddish white. These worms are more 
especially common in puppies, who may be infested 
with them at three or four weeks old, but it is 
at the age of three or four months that they are 
most abundant. Their habitat is the small intestine 
and frequently the stomach. 

Symptoms. — Unthrifty coat, emaciation, enlarged 
abdomen (pot-belly), variable appetite, sometimes 
convulsions, colics, and constipation or diarrhea re- 
sult from infestation by this parasite. By collecting 
in rolled-up masses the parasites sometimes cause 
complete intestinal obstruction, which is followed 
by death. In one case in the author's practice the 



PARASITES 167 

stomach and intestines of a month-old puppy were 
found on " postmortem examination to be tightly 
packed with worms, which, when removed, com- 
pletely filled a six-ounce bottle. 

Treatment. — All solid food must be withheld for 
twelve hours, when capsules containing calomel and 
santonin, one-half grain of each, should be admin- 
istered every three hours until purgation takes place. 
The following prescription has given complete satis- 
faction to the author in numerous cases : 

I> Fluidextracti spigelise, 

Fluidextracti sennae, aa oz. i 

Sig. — Give 15 to 30 minims every morning until three doses 
have been given. 

There are many other vermifuges applicable, but 
whatever one is used, a laxative should either 
be combined with it or administered after the last 
dose, and in every case of worm infestation the 
treatment should be repeated every two weeks until 
the feces show no evidence of parasites or of their 
ova. All feces of infected dogs should be burned 
to prevent other animals from becoming infested. 

Oxyuris Vermicularis 

This is a small, white, thread-like worm, the male 
from two to three millimeters long, the female from 
nine to ten millimeters long. These parasites in- 
habit the rectum and cause considerable irritation 
and anal pruritus ; the patient continually drags 
the anus along the floor to relieve the itching. 

Symptoms. — Anal pruritus and the presence of 
the parasites in the feces prove the presence of the 
parasite. 

Treatment. — A laxative should be administered, 
followed by enemas of a saturated solution of sodi- 
um chlorid or a strong infusion of c|uassia chips. 



168 CANINE MEDICINE AND SURGERY 

Ankylostomum Trigonocephalum 

The hookworm is white in color, the male from 
nine to twelve millimeters long, the female from 
nine to twenty-one millimeters long. These para- 
sites inhabit the small intestines and produce grave 
symptoms. They are true bloodsuckers, producing 
pernicious anemia. 

Symptoms. — The symptoms are those of grave 
anemia — a gradual but progressive emaciation, and 
debility. The appetite is unaffected at first, but 
later on becomes capricious and finally disappears. 
The coat is staring, the skin scaly and dry. The 
nose is tumefied and becomes excoriated with the 
mucosanguinolent discharge. Later a copious 
epistaxis supervenes, two or three ounces of blood 
being lost at each attack. These attacks of epis- 
taxis recur at intervals of a few days to several 
weeks, during which the mucosanguinolent dis- 
charge continues. 

In some cases convulsions occur. Intermittent 
edematous swellings make their appearance on the 
limbs, which finally become permanenth^ edematous. 
In the last stage there are ulcerations, gangrenous 
patches, and persistent diarrhea, which may give 
place to dysentery. The course of this condition 
is extremely chronic, the animals lingering for 
months or even a year. 

Treatment. — When pernicious anemia appears in 
a pack of hounds extreme care should be taken to 
thoroughly clean and disinfect the kennels. The 
sick should be isolated and prevented from soiling 
the drinking troughs, they should be fed and 
watered in individual utensils which should be 
boiled immediately after use, and their feces should 
be burned. 

The anthelmintic which has been proved to be 



PARASITES 



169 



of the greatest service is thymol given in large 
doses and followed up by a saline laxative. Oil of 
male fern is also very efifectual. This latter should 
be given only after the patient has been fasted for 
twenty-four hours, having previously received a 
purgative. Six to eight hours after the exhibition 
of the male fern a saline purgative should be given 
to clean the intestinal canal. The strength of the 
patient must be carefully maintained by nutritious 
and easily digested foods — milk, and raw meat — 
with tonics of iron and a bitter tonic such as quas- 
sia or gentian. 

Tricocephalus Depressiusculus 

A white worm forty-live to seventy-five milli- 
meters long. This parasite inhabits the cecum of 
the dog and is often found in conjunction with the 
Ankylostomum trigonocephalum. It produces anemia 
and often typhlitis — appendicitis. 

Treatment. — The same as for Ankylostomum trig- 
onacephalum. 

Taenia — Tapeworms 

The tapeworms most commonly, met with in the 
dog are merely mentioned here and the reader is 
again referred to works on parasitology for a more 
extended description. The fuliuwmg table gives the 
name, the intermediat.^ host, and the larval form : 



Name 



Intermediate 
Host 



Larval Form 



Taenia Serrata. . . 

Taenia Serialis. . ., 
Taenia Marginata. 

Taenia Coenurus. . 
T. Echinococcus. 



Tjenia Canis 

Taenia Krabbei. . , 



so cm. to 2 m. 



45 cm. to 75 cm. 
1.5m. to 2 m. . . . 



SO cm. to 75 cm. 
4 mm. lo 5 mm.. 



10 cm. to 40 cm. 
I m 



Hare and rabbit. . 



Rodents . . 
Ruminants 



Sheep 

Man, swine, rumi- 
nants 



Louse and flea. 
Reindeer 



Cysticercus pisi- 
form is 

Ccenurus serialis 

Cysticercus tcnui- 
collis 

Ccenurus ccrebralis 

Echinococcus poly- 
morphous 

Cryptocystus trich- 
odectis 

Cryptocystus serra- 
ticeps 



170 CANINE MEDICINE AND SURGERY 

Of these tapeworms the most important from an 
economic standpoint are the Taenia echinococcus 
and the Taenia coenurus, the first producing hydatid 
disease in man, the second "gid" in sheep. 

The symptoms of tapeworm infestation are those 
of general parasitism, and the diagnosis is positive 
when the segments are found in the feces. 

Treatment. — After thoroughly preparing the ani- 
mal by fasting and laxatives, administer on an 
empty stomach fifteen minims to one dram of oil 
of male fern, followed in eight to ten hours by a 
saline cathartic in full doses. The expelled para- 
sites should be carefully examined to ascertain if 
the head has been expelled, and if not the treatment 
should be repeated in ten days. The same precau- 
tions as to burning worm segments and the bowel 
discharges must be taken as mentioned before in 
this section. 



SECTION XXI 

POISONS AND POISONING 

POISONING in the dog may be accidental or 
intentional. The former may come about by 
the animal picking up poisoned meat or other food 
laid down for vermin, or the patient may ^show 
symptoms after an overdose of some drug given 
empirically. Some animals show a great suscepti- 
bility to the action of some drugs, notably strych- 
nin, symptoms of poisoning appearing after even 
moderate medicinal doses. Poisons cause death 

1. By their corrosive or tissue-destroying proper- 
ties ; 

2. By their physiological action ; 

3. By a combination of (1) and (2). 
Poisoning in canine patients, whether intentional 

or accidental, is only too often fatal, the quantity 
of the drug ingested in nearly every case being 
large and the patient's condition often not discovered 
until irreparable damage has been done. The usual 
portals through which poisons are absorbed are the 
respiratory and digestive system, with air or food. 
Occasionally they are absorbed through wounds in 
the skin. 

Pathology of Poisoning 

Local Effects. — These are the results of the action 
of the poison on the living cells with which it 
comes in contact and consist of more or less violent 
irritation, varying in degree from congestion or in- 
flammation to mortification, and these local effects 
react on the whole system, giving rise to fever, col- 
lapse, and other serious conditions. 

171 



172 CANINE MEDICINE AND SURGERY 

Absorption. — The rapidity with which poisons 
are absorbed depends to a great extent on the 
poison itself, the portal by w^iich it gains entrance 
to the animal's economy, the condition of the diges- 
tive tract — whether full or empty, and also the 
nature of the stomach contents. For instance, the 
unbroken skin will easily and rapidly absorb gases, 
but solids or liquids hardly at all ; on the other 
hand, irritated or woundca skin becomes very ab- 
sorbent. Again, an empty stomach will absorb 
far more readily and rapidly than a full one, and 
yet again, the digestive tract just after a meal 
of fatty substances, even milk, is far more impene- 
trable than when a meal with no fat has been par- 
taken of. The exception to this is phosphorous, the 
absorption of which is accelerated by oils and fats. 

Elimination. — Poisons are eliminated in the excre- 
tions. Nearly all mineral poisons are eliminated 
through the kidneys, some by the bowels. Gases, 
vapors, and volatile poisons are eliminated by the 
lungs. Some poisons undergo changes during elimi- 
nation, others are eliminated unaltered. 

Treatment. — The main objects to be attained are 
to delay or prevent absorption, to neutralize the 
poison or render it insoluble, to eliminate from the 
system both what is absorbed and what is unab- 
sorbed, and to counteract the efifects produced by 
the poison absorbed and the resulting lesions. 

The first can be accomplished by emetics and 
purgatives, the former by reason of their rapidity of 
action being the most valuable. Purgatives are 
chiefly valuable when combined with agents that 
retard absorption or with those that unite with 
poisons and form insoluble or inert compounds. 
Antidotes act in three ways : they neutralize the 
poison, render it insoluble, or arrest its injurious 
effects. 



POISONING 173 



Arsenic 



Arsenic, or rather arsenious acid (arsenic trioxid), 
is one of the commonest of vermin poisons, and 
dogs are frequently poisoned on that account. Dogs 
may also become poisoned by the arsenic in an 
overdose of Fowler's solution given for medicinal 
purposes. 

The toxic dose of arsenic is two grains. Arsenic 
is a corrosive irritant, producing gastroenteritis, 
with its corresponding efifects. 

Arsenical poisoning may be either acute or sub- 
acute. 

Symptoms of Acute Arsenical Poisoning. — About 
an hour after ingestion there suddenly appears 
profuse salivation, swallowing movements, and great 
thirst. The patient is restless and anxious, with 
convulsive action of the lips, acute colicky pains, 
and vomiting. There is great pain over the epi- 
gastric region, and intolerance to pressure. At 
first there is constipation, which later on gives 
way to a fetid dysentery. The pulse at first is full, 
but soon becomes small, irregular, and impercepti- 
ble; respiration is difficult, urine scanty and often 
bloody, and the temperature is subnormal and the 
extremities cold. Later on rigors set in, with 
weakness and paresis, the gait is staggering, the 
pupils dilated. The pain is excruciating, and the 
animal dies in a state of collapse in from four to 
five hours. 

Symptoms of Subacute Arsenical Poisoning. — There 
are much the same as in the acute form, but not 
so violent. There is dryness of the mouth, great 
thirst, colicky pains, vomiting, fetid diarrhea, and 
tympanites. The mucous membranes are pale, 
the pulse irregular but frequent, the urine scanty. 
These symptoms may persist for about twenty-four 



174 CANINE MEDICINE AND SURGERY 

hours, when the patient seems to improve. This 
improvement, however, is short-lived, the patient 
soon relapsing and becoming worse. There is great 
depression and weakness and he is unable to stand. 
Dyspnea is present, and the pulse is weak and 
almost imperceptible. Convulsions may occur, or 
the patient may lapse into coma. There may be 
edema of the eyelids and dependent parts ; paralysis 
of the hind quarters then sets in, and death fol- 
lows in a day or two. 

Treatment. — Administer an emetic, 1-20 to 1-10 
grain of apomorphin, and follow with an antidote. 

Antidote : Sesquioxid of iron prepared by pre- 
cipitating tincture of iron perchlorid with an alkali. 
Large amounts of this antidote should be given 
every twenty minutes or so, followed up by a 
purgative of magnesium sulphate. Three ounces 
tincture of iron perchlorid, and one ounce of sodium 
carbonate, dissolved in water and mixed together, 
will produce sufficient sesquioxid to neutralize ten 
grains of arsenious acid. Insoluble arsenate of iron is 
formed and is swept out by the magnesium sulphate. 

In acute cases hypodermic injections of morphin 
every half hour will retard absorption and ease 
pain. Later on and in subacute cases, opium com- 
bined with a demulcent has the same effect and 
tends to soothe the inflamed mucous surfaces. To 
hasten elimination, spiritus etheris nitrosis should be 
given in full doses, well diluted with water. Collapse 
must be combated wth stimulants. 

Phosphorus 

Phosphorus poisoning in dogs is usually acci- 
dental, and due to their picking up pieces of bread 
or meat smeared with vermin paste of which phos- 
phorus is the chief constituent. 

Symptoms. — The first symptoms of phosphorus 



POISONING 175 

poisoning generally appear about an hour after the 
ingestion of the poison, manifestations of acute gas- 
tritis, increased flow of saliva, acute pain, bloody 
diarrhea, extreme prostration, convulsions, and coma 
occurring in rapid succession. A garlicky odor of 
breath and icterus complete the clinical picture. 
If the patient is taken into a darkened room, his 
breath, feces, and urine appear luminous. If the 
patient survives the acute symptoms, fatty degener- 
ation, chiefly of the liver, takes place, from which 
the animal may die later on. 

Treatment. — An emetic of two grains of copper 
sulphate in water should be given and repeated 
until the stomach is completely emptied. Copper 
sulphate is both an emetic and an antidote for 
phosphorus, forming an insoluble phosphid of cop- 
per. After all the poison has been ejected by 
vomiting that it is possible to eject in this way, 
demulcents and opiates should be given, but on 
no account should oil or milk be used, as they 
hasten the absorption of the phosphorus. To coun- 
teract the extreme prostration and collapse asso- 
ciated with phosphorus poisoning, subcutaneous in- 
jections of strychnin sulphate (gr. 1-200 to gr. 1-60) 
or one-half to one ounce of spirits of camphor 
should be given. 

Strychnin 

Strychnin poisoning is probably the most com- 
mon form of poisoning with which the veterinarian 
has to deal. The dog poisoner generally chooses 
this powerful alkaloid to attain his nefarious ob- 
ject. In addition, canine patients are extremely 
susceptible to strychnin and poisoning frequently 
results from overdosage of this drug. These lat- 
ter cases, however, are usually quickly amenable to 
treatment. In malicious poisoning, on the other 



176 CANINE MEDICINE AND SURGERY 

hand, the mortality is high on account of the mas::- 
ive doses employed. 

The length of time which elapses before symp- 
toms of poisoning appear after the ingestion of 
toxic quantities of strychnin varies considerably, 
depending on the nature and amount of food in the 
stomach. Absorption is retarded by a full stomach 
and by food stuffs of a fatty nature. The author 
has records of a case in which this delayed ab- 
sorption is well illustrated. The patient on her 
return home was given a bowl of milk, after which 
she was under continual observation until the symp- 
toms of strychnin poisoning developed, a period of 
four hours. The dose in this instance must have 
been a large one, as the bitch was saved only by 
heroic doses of H-M-C, being kept narcotized for 
twenty-four hours. 

Symptoms. — Uneasiness, an anxious expression, 
and panting, followed by acute tetanic spasms at 
varying intervals, are indications of strychnin 
poisoning. The spasms affect the whole body, the 
limbs become stiffened, and the animal, unable 
to stand, falls to the ground. The jaws are in a 
state of trismus, the lips being drawn back, espe- 
cially at the commissures, producing the character- 
istic risus sardonicus. The spine is curved (lordosis), 
inspiration is labored, and the mucous membranes 
are cyanotic. The eyes are prominent, the pupils 
dilated, the heart action tumultuous, and the pulse 
small and c{uick, but the artery full and hard. 
After the spasm the muscles relax and the fore- 
going symptoms abate until another paroxysm sets 
in, and these become more and more frequent, with 
shorter intervals, until ultimately the patient dies 
from asphyxia during one of the convulsions. 

Treatment. — Immediately an emetic of 1-10 to 
1-20 grain of apomorphin hydrochlorid should be 



POISONING 177 

administered hypodermically to produce prompt vorrti- 
tion of the unabsorbed portion of the poison. No mat- 
ter wliat treatment is resorted to for the purpose of 
allaying^ the spasms, this emetic must be given first of 
all; V'-iless the quantity of strychnin ingested be very 
small, all other treatment is futile, and a fatal termi- 
nation certain if this is neglected. 

If the patient can swallow, the emetic may be 
followed by a liberal dose of oil. To control the 
spasms, the animal must be chloroformed, or an 
intravenous injection of chloral hydrate may be 
given. Large doses of morphin sulphate may also 
be used subcutaneously ; but the treatment that has 
given the best results, and has in addition the ad- 
vantage of easy administration, is the hypodermic 
injection, after the production of emesis, of from 
three to five tablets of H-M-C (No. 1). The main 
object is to keep the patient free from spasms until 
the poison is eliminated. These injections of the 
H-M-C tablets should be repeated in sufficient dose 
to attain the result, the procedure being entirely 
without danger. The patient when completely nar- 
cotized should be placed in a dark and quiet place 
and all noise and excitement avoided,- or a return 
of the paroxysms will result. 

Hydrocyanic Acid and Potassium Cyanid 

These poisons are sometimes used by the dog 
poisoner, the latter being the more used of the two. 

Symptoms. — The rapidity with which this poison 
usually acts does not allow of the development of 
definite symptoms, but when relatively small toxic 
doses have been given (luckily the commercial potas- 
smm cyanid is often impure) the following symptoms 
appear in a few minutes after the ingestion of the 
poison : Great distress, difficulty in breathing, head 
and neck extended, and convulsive movements of 



178 CANINE MEDICINE AND SURGERY 

the fore limbs. The patient next falls on his side 
and goes into convulsions, the spine being alter- 
nately arched (kyphosis) and curved (lordosis). 
There is champing of the jaws, an increased flow of 
saliva, spasms of the diaphragm, asphyxia, and death. 
Treatment, — Death usually takes place so quickly 
as to preclude treatment, but if there is time, 1-10 
to 1-20 grain of apomorphin hydrochlorid should 
be given for its emetic elTect, and the poison neutral- 
ized with a solution in water of ten grains of iron 
sulphate. Complete anesthesia should then l)e ■ in- 
duced by the administration of ether. 

Carbolic Acid (Phenol) 

Dogs are extremely susceptible to the effects of 
carbolic acid and are often poisoned by being washed 
in a strong solution for the eradication of vermin, 
or by licking wounds to which carbolic dressings 
have been applied. 

Symptoms. — When taken by the mouth the caustic 
action of carbolic acid is observed by the stomatitis, 
pharyngitis, and gastroenteritis which it produces. 
The mucous membranes that have l:)een touched by 
it appear white in patches. When phenol is absorbed 
into the general circulation the following symptoms 
appear: 

The patient is anxious and distressed ; there are 
fits of rigors and convulsions followed by paralysis 
of the hind quarters ; the pulse is small, irregular, 
and barely perceptible ; the respiration is quick and 
difficult ; the temperature subnormal, and the urine 
high colored. 

Treatment. — Alcohol neutralizes carbolic acid and 
is, in addition, a stimulant. It should l)e given in full 
doses, one to two ounces, or if it be obtainable give 
gin, one to four ounces. A full dose of sodium sul- 
phate should then be given for a purgative. This 



POISONING 179 

also in a measure neutralizes the poison. The in- 
flamed mucous membranes should be soothed by the 
administration of oil or demulcents. The failing res- 
piration should be combatted by repeated full doses 
of atropin sulphate (1-100 to 1-25) administered 
hypodermically. 

Iodoform 

Poisoning from this agent is usually due to absorp- 
tion from wound dressings or from the patient lick- 
ing wounds that have been dressed with iodoform. 

Symptoms. — Gastric disturbances, vomiting, con- 
stipation, and convulsions alternating with coma, 
are produced by the ingestion or absorption of toxic 
quantities of iodoform. In some cases there is great 
excitement and dif^cult breathing. The pulse is 
irregular. 

Treatment. — Eliminate by emetics and give starch 
to form insoluble starch iodid. 

The foregoing list of poisons comprises those usu- 
ally met with in practice ; for a more extended list, 
the reader is referred to special works on toxicology. 



PART II 
SURGICAL OPERATIONS 

SECTION I 
PRELIMINARIES 

THE successful carrying out of an operative pro- 
cedure depends partly on the skill of the oper- 
ator and still more on the rigid adherence to the 
rules of asepsis and antisepsis. To attain these es- 
sentials, some means of restraining the patient's 
movements must be provided for. There are numer- 
ous and varied types of operating tables to be found 
on the market, but for all practical purposes a per- 
fectly efficient table may be devised at home. An 
ordinary kitchen table, enameled white, makes a 
thoroughly practicable and cheap substitute for the 
high-priced tables sold by the svirgical supply houses. 

The top of the table should be removed and fixed 
on again with hinges at one end, to allow the top 
to be tilted at any angle. At the other end of the 
framework of the table a square frame is hinged, 
the top of which butts against slats screwed on the 
inferior surface of the table top. In this way vari- 
ous angles of inclination may be obtained. 

On the table top are screwed four cleats, one 
at each corner, to which to affix the hopples. The 
hopples themselves may be made of tape, small- 
sized cotton rope, or webbing. A loop is made in 
one end of the hopples and a slipknot formed by 
passing the other end through the loop. In secur- 
ing the patient the slipknots are placed on each leg, 
above the carpus or the tarsus, as the case may be, 
the patient stretched out, and the ends of the hop- 

180 



ANESTHESIA 181 

pies passed round the cleats in figure-of-eight style. 
The positions in which the patient is placed are 
the abdominal and the ventral. In the former the 
patient is stretched on the table on his belly ; in 
the latter, on his back. Occasionally the position 
of lateral recumbency is required, when the patient 
is placed on his side and the feet secured to the 
cleats opposite to each other. 

Anesthesia 

To obtain the best results, as well as for humani- 
tarian reasons, all operations (with the exception, 
perhaps, of evacuating an abscess, which as a rule 
requires only one bold stroke of the knife) should 
be performed under anesthesia. 

Anesthesia may be either local or general. As a 
general rule local anesthesia is applicable only in 
minor operations of short duration. It is applied 
by a spray to the part to be operated on, or the 
part is injected subcutaneously, by means of an 
ordinary hypodermic syringe, with the anesthetic 
selected. Ethyl chlorid is sprayed on the site of 
operation until the tissues are nearly frozen. It is 
of use oniy in such operations as opening an abscess 
or giving an intravenous injection, because the 
anesthesia is only fleeting and cannot be pushed on 
account of the danger of the tissues sloughing from 
too prolonged freezing. The anesthetics admin- 
istered hypodermically are solutions of cocain, 
eucain, urea and quinin hydrochlorid, alypin, acoin, 
novocain, and stovain. Of these cocain is probably 
the most used and is quite safe, provided that the 
amount injected does not exceed three-fourths of 
a grain. Although solutions of varied strength may 
be used Avith the above limitation as to dose, a 
four-per-cent solution is found to be the most suit- 
able for general work. It must be remembered that 



182 



CANINE MEDICINE AND SURGERY 



cocain has toxic properties and that no more than 
a tenth of a grain per pound weight of the patient 
should be injected at one time. The addition of 
adrenalin to the solution not only delays absorption 
into the circulation and so diminishes the risk of 
poisoning, but by constricting the capillaries it 
renders the operative field comparatively bloodless — 
a great advantage in some operative procedures. 

Technic. — The site of operation is shaved and 
cleaned up as described hereafter, and a sterilized 
hypodermic syringe is filled with the anesthetic 
solution. A sterilized needle is introduced under 
the skin in the usual manner, the syringe attached, 




Chloroform Inhaler. 

a few drops injected, and the needle withdrawn. 
Within the wheal produced by the first injection the 
needle is again introduced and another injection 
made, and so on until the whole operative area is 
injected. Gentle massage to the part is then applied 
for a minute or so in order to distribute the solu- 
tion. A pause of about fifteen minutes must be 
made before commencing the operation. 

General Anesthesia 

Being so easily and safely induced, general anes- 
thesia in canine practice is by far the most prac- 
ticable and satisfactory. The general anesthetics 
most in vogue are chloroform and ether, but various 
mixtures of these, with or without the addition of 
alcohol, are often substituted, but with no a'dvan- 



ANESTHESIA ' 183 

tage to the patient. The safest and most desirable 
method of inducing general anesthesia is as follows : 

About one hour previous to the operation the pa- 
tient should receive a hypodermic injection of H-M-C 
(hyorcin, 1-100; morphin, 1-4; catin, 1-64), this 
usually produces vomiting in ten minutes. The 
dose must be gauged by the animal's age and gen- 
eral condition, and varies from one No. 1 tablet for 
a puppy or small dog to five No. 1 tablets for a 
collie or bull terrier. The anesthetic is then com- 
pleted by a few whilTs of chloroform administered 
by means of a Funker's inhaler or some similar 
apparatus. The advantages gained by using this 
method are (1) the emptying of the stomach; (2) 
the small amount of chloroform required to produce 
profound but safe anesthesia ; (3) the long post- 
operative hypnosis that the patient enjoys, with corre- 
sponding benefit to the healing process. 

Chloroform alone may be quite safely administered 
if due considerations are given to the following de- 
tails : 

1. The patient must be prepared by fasting and 
the exhibition of a laxative twelve hours previous to 
operation. 

2. The anesthetic must be administered slowly 
and be largely diluted with air. 

3. The anesthetic must be administered only in 
sufficient quantity to inhibit the reflexes. 

4. A sharp lookout must be kept for the danger 
signal, namely, shallow respirations. It, must be 
remembered that it is the respiratory center that 
first becomes paralyzed, and that respiratory failure 
precedes cardiac failure. 

5. At the first sign of respiratory trouble the 
anesthetic must be immediately discontinued, stimu- 
lants given, and if need be artificial respiration per- 



184 CANINE MEDICINE AND SURGERY 

severed with until normal breathing is again estab- 
lished. 

6. In case of sudden collapse, every effort must 
be made to reestablish respiration. Remove the 
chloroform mask at once, pull the tongue forward 
with the tongue forceps, and drop on the back of 
the tongue the requisite dose of Scheele's acid.* The 
dose of the acid is one-eighth of a minim for each 
pound in weight of the animal. The sudden gasping 
which immediately takes place- on the administering 
of hydrocyanic acid in a large majority of cases 
starts the respirations again. Then give the patient 
a smell of strong ammonia and a hypodermic of 
1-100 to 1-50 grain of strychnin, according to its size. 
If these measures fail, give adrenalin solution (1-1000) 
hypodermically. In addition to this medicinal treat- 
ment, artificial respiration must be resorted to. 

Technic. — The following apparatus, instruments, 
and drugs are required to be ready to hand : Chloro- 
form apparatus as illustrated, chloroform, strong 
ammonia, Scheele's acid (one eighth minim to a 
pound weight of patient), medicine dropper, hypo- 
dermic syringe filled with strychnin solution (1-50 
grain), adrenalin solution (1-1000), and tongue 
forceps. 

Administration. — The patient should be secured in 
the abdominal position on the table and the mask 
applied over the nose and mouth. The anesthetist 
then gently squeezes the bulb of the apparatus, 
taking care to give the patient plenty of time, after 
the first struggles have subsided, and the patient 
passes into the second or narcotic stage, recognized 
by a series of short, sharp yelps or whining. Then 
the chloroform may be pushed faster until the anes- 



*A flve-per-cent aqueous solution of absolute hydrocyanic acid; 
named for Carl Wilhelm Scheele (1742-1786), a Swedish chemist, 
discoverer of chlorin and oxygen. 



STERILIZATION OF INSTR JMENTS 185 

thetic stage is reached, as shown by the abolition of 
reflex action. The administration of the anesthetic 
must then be continued with great caution, the bulb 
being squeezed only often enough to maintain 
anesthesia. 

If due regard is given to this method of anes- 
thetizing, the patient is kept well within the safety 
zone and accidents will be of rare occurrence. The 
author has anesthetized hundreds of cases by this 
method, which is followed by Professor Hobday, 
without a single fatality. 

Preparatory Treatment of the Operative Area 

This most important preliminary must in all cases 
be rigidly carried out, as only by surgical cleanliness 
can healing by primary union be brought about. 

Technic. — All hair should be removed by clippers 
or scissors, the part thoroughly scrubbed with anti- 
septic soap and boiled water, and then shaved. The 
site of operation should then be rinsed with boiled 
water, or rubbed with swabs dipped in ether or 
gasolin, to remove the greasy secretion of the skin. 
This must be persisted in until the swabs come away 
perfectly clean. Tincture of iodin is then applied 
and allowed to dry, the process being repeated three 
times. The body of the patient should be covered 
with gauze wrung out in boiled water, to prevent 
hairs or dust getting into the wound during the 
operation. 

Preparation of Instruments 

One of the most important factors in the success- 
ful healing of surgical wounds is the prevention of 
pathogenic organisms being introduced either by 
instruments, sutures, dressings, or the operator's 
hands. In other words, everything that comes in 
contact with a wound must first of all be rendered 
aseptic. Instruments can readily be sterilized by 



186 CANINE MEDICINE AND SURGERY 

boiling for fifteen minutes. A piece of ordinary 
washing soda should be added to prevent discolora- 
tion and rusting. The instruments can then be laid 
in a sterile dish or instrument tray containing some 
sterile solution. 

The author particularly wishes to emphasize the 
point that boiling is the only safe method of sterili- 
zation, and that putting instruments into an anti- 
septic solution of a strength that will not injure them 
is quite ineffective for the purpose of sterilization. 

Preparation of the Operator's Hands 

This is one of the most important details that 
must be attended to, and at the same time the most 
difficult of accomplishment. The varied duties aris- 
ing in veterinarian practice make the possession 
of the ideal soft, white, and sensitive surgeon's 
hands almost an impossibility. Try as we may, our 
hands get rough, chip])ed and cracked, and there- 
fore form a suitable habitat for microorganisms. The 
safest and best way when operating is to wear rub- 
ber gloves, which can easily be sterilized, thereby 
saving an immense amount of time and trouble. 
For those, however, who dislike gloves the following 
routine may be of service : Wear leather gloves 
while securing the patient, then before operating 
clean the nails, scrub well with hot water and soap 
for five minutes, then in alcohol, then in 1-1000 solu- 
tion of bichlorid of mercury for five minutes, then 
rinse off in two changes of boiled water. It must 
be always borne in mind that after the hands are 
once cleaned nothing that is not surgically clean — 
that is, aseptic — must be touched. Should this oc- 
cur, the hands must again be disinfected before 
touching the wound. Owing to the extreme diffi- 
culty of rendering the hands surgically clean, it is 
best to handle the wound or tissues as little as 



DISINFECTION OF THE HANDS 187 

possible with the fingers. With a little practice, 
nearly all manipulations required can be clone with 
instruments. Take, for instance, the suturing of a 
wound : the edges are grasped with tissue forceps, 
the ntedle held in a needle forceps or holder, and the 
suture placed without fear of contamination from 
the operator's fingers. 



SECTION II 

SURGERY OF THE HEAD AND NECK 
Hematoma of the Ear Flap 

HEMATOMA consists of an effusion of blood 
or serum between the skin and cartilage. It 
is due to trauma, and first appears as a painful 
fluctuating swelling on either the under or upper 
surface of the ear flap, or in some cases on both 
surfaces. If not dealt with the contents of the sac 
become organized and by contraction produce a most 
unsightly distortion of the ear. 

Materials for operation. — The following instru- 
ments, sutures, and dressings are sterilized and 
placed in sterile trays ready for use : One scalpel, 
two pairs of artery forceps, one needle forceps, ten 
straight needles, ten silkworm-gut sutures, one 
curette, one dressing forceps, cotton-wool swabs, 
aseptic gauze, dressing (iodized collodion), aseptic 
wool (ether), one ear cap or many-tailed bandage, 
a piece of rubber sheeting ten by twelve inches in 
size with a slit three inches long in the middle. 

Place the patient in the abdominal position and 
induce general anesthesia. 

Technic. — Both sides of the ear flap are shaved 
and prepared as before described. The external 
auditory meatus is plugged with cotton wool and 
the ear pulled through the slit in the rubber sheet, 
which is laid over the patient's head and neck in 
order to prevent the operative area touching it. 

A longitudinal incision is made in the center of 
the swelling, sufficiently large to permit of the 
complete evacuation of the contents, which may 

188 



SURGERY OF THE EAR 189 

consist of blood or serum, clots, and tissue debris. 
The cavity between the skin and cartilage is then 
gently but thoroughly curretted and any hemorrhage 
controlled by pressure. The next step is to suture 
the wound and completely obliterate the cavity be- 
tween the skin and cartilage. 

Method of Suturing. — The needle is introduced 
from the opposite side of the ear flap through the 
skin and cartilage so that it comes through about 
one eighth of an inch from the edge of the wound. 
The suture is taken across the wound and up 
through the flap again, and tied. The sutures must 
be placed about one eighth of an inch apart and be 
of sufficient number to completely close the wound. 

Additional sutures placed in the same manner are 
then put in where required to obliterate the cavity 
and insure close approximation of the skin and carti- 
lage. The ear is then swabbed with ether, the 
wound sealed with iodized collodion, and the whole 
ear enveloped in a sterile gauze and wool dressing, 
laid on the top of the head, and the ear cap or many- 
tailed bandage applied. 

The position of the ear should be changed every 
twenty-four hours ; that is, bandaged over the top 
of the head or against the cheek. The dressings 
should be removed on the fourth day and the wound 
examined. As a rule, with good technic healing is 
by first intention, but if not the ear is cleaned every 
day with hydrogen peroxid and dressed with anti- 
septic dusting powders and dressings, gauze and 
wool, until healed. The sutures are removed on the 
seventh day. 

Plastic Operation for Split Ears 

Split or torn ear flaps are commonly the result of 
fighting, and unless remedied give the patient a 



190 CANINE MEDICINE AND SURGERY 

most unsightly appearance and detract considerably 
from its value. 

Experience teaches that simple suturing of the 
torn parts is most unsatisfactory, since the parts 
do not as a rule heal properly, the stitches tearing 
out and the edges of the wound again separating. 
By using the following technic, however, uniformly 
good results are obtained to the satisfaction of the 
owner and surgeon : 

Place the patient in the abdominal position and 
induce general anesthesia, having the following in- 
struments, dressings, and so on ready for use : A 
small scalpel, dressing forceps, artery forceps, 
needles and fine silk sutures, iodized collodion, ether, 
swabs, and gauze. 

Technic. — The instruments, needles, sutures, swabs, 
and gauze are sterilized by boiling and the ear shaved 
and carefully disinfected in the usual manner. The 
ear is then pulled through a slit in the gauze so as tO' 
prevent it coming in contact witli the head or neck 
during the operation. 

After thoroughly disinfecting his hands, the oper- 
ator then takes the scalpel and dissects the skin 
away from the cartilage for about one eighth of an 
inch on both sides of the ear and on either side of 
the wound. The strips of cartilage thus freed from 
the skin are then excised, hemorrhage controlled, 
and the edges of the wound on both sides united 
with closely placed interrupted sutures. The wound 
is then swabbed with ether, which is allowed to 
evaporate, and sealed with the iodized collodion. 
Healing occurs by first intention and the sutures are 
removed in six days. 

Operation for Harelip 

Place the animal in the abdominal position and 
induce general anesthesia with H-M-C and chloroform. 



OPERATION FOR CLEFT PALATE 191 

For materials to be used have ready a scalpel, scis- 
sors, tissue forceps, artery forceps, harelip pins, silk 
sutures, needles and wire cutters (all to be sterilized 
by boiling) ; also the necessary dressings, sterile 
swabs and iodized collodion. 

Technic. — The edges of the cleft are "rawed" up 
with the scalpel and the mucous membrane uniting 
the under surface of the lip to the gums dissected 
loose, so that there is no tension on the lip when 
the edges of the cleft are approximated. This is 
the essential part of the operation. 

The edges of the cleft are then united by passing 
the harelip pins through the wound and passing 
the silk sutures around them in a figure of eight. 
The pins should be placed about one quarter of an 
inch apart. The bottom of the cleft at the edge of 
the lip is united with a single suture and the whole 
sealed with collodion after cutting off the super- 
fluous portions of the pins with the wire cutters. 

Operation for Cleft Palate 

Place the animal in the dorsal position and induce 
general anesthesia with H-M-C and chloroform. The 
following instruments must be at hand : palate knife, 
scissors, mouth gag, palate needles, silk sutures, 
needle holder, swabs and swab holder, all to be 
sterilized by boiling. 

Technic. — An incision is made parallel with and 
on each side of the cleft through the maicous mem- 
brane of the palate, which is then loosened from the 
bone with the points of the scissors (Chury's opera- 
tion). The object of this is to enable the operator 
to approximate the edges of the cleft without ten- 
sion on the sutures. 

The edges of the cleft are scarified and approxi- 
mated with fine silk sutures placed one third of an 
inch apart. 



192 CANINE MEDICINE AND SURGERY 

Esophagotomy 

When a foreign body becomes so firmly lodged 
in the esophagus that it cannot be moved by the 
forceps or probang, the esophagus must be opened 
and the foreign body extracted. If in the cervical 
region the procedure is as follows : Place patient 
in the dorsal position, with neck well extended. Then 
apply a local anesthetic of four-per-cent solution of 
cocain and adrenalin. Have at hand a razor, scal- 
pel, artery forceps, tissue forceps, needles, catgut 
sutures, and silk sutures. 

Technic. — The operative area is shaved and dis- 
infected in the usual manner and the cocain solu- 
tion injected subcutaneously. 

An incision above the foreign body is made 
through the skin with the scalpel, and the esophagus 
is exposed by blunt dissection, the vessels and nerves 
being pushed aside. The esophagus is then incised 
and the foreign body extracted. Then the esophageal 
wound is closed with catgut sutures, first the mucous 
membrane and then the muscular and fibrous layers 
of the wall. 

The skin incision is sutured with silk, drainage 
being provided for at the lower margin of the 
wound. 

Water must be withheld for at least twenty-four 
hours and all food for four days, the patient being 
fed pel' rectum, after which well minced and sloppy 
food may be given in small quantities. Unless this 
part of the treatment is fully carried out, healing 
is interfered with, infection invariably takes place, 
and an esophageal fistula often results. 

Tracheotomy 

Tracheotomy, or incision into the trachea for the 
purpose of inserting a tube, is essentially an emer- 



TRACHEOTOMY 193 

gency operation in the dog to avert impending suf- 
focation during attacks of laryngitis, foreign bodies 
in the pharynx or esophagus, and sometimes in 
cases where the nasal chambers l)ecome plugged with 
clotted blood or mucous. 

.Place the patient in the dorsal position, with neck 
fully extended, and ai)ply a local anesthetic of cocain 
and adrenalin solution. The following instruments 
must be ready for use : scalpel, razor, rat-tootheJ 
forceps, tracheal retractor, and tracheotomy tube. 
Also have plenty of dressings and swabs at hand. 

Technic. — After shaving and disinfecting an area 
about three inches square immediately below the 
larynx, a median incision is made through the skin 
and muscles onto the trachea. The incision should 
begin about one inch below the larynx and extend 
backwards about one and one-half inches. Hemor- 
rhage must be completely controlled before the 
next step of incising the trachea is taken. The 
trachea is then seized with the rat-toothed forceps 
and an incision made in its middle line, long enough 
to allow of the insertion of the tube. To facilitate 
this, the trachea wound should be dilated with the 
retractor, as otherwise considerable difficulty may 
be experienced in inserting the tube. The after- 
treatment consists of removing the tube daily and 
cleaning it, cleaning the wound, and reinserting the 
tube. After permanent removal, the wound should 
be treated antiseptically and allowed to heal by 
granulation. 



I 



SECTION III 

SURGERY OF THE EYE 
Injuries 

NJURIES to the orbit are fairly frequent from 
blows, kicks, collisions, and other causes, and 
may involve the surrounding soft tissues, bones, or 
contents. Treatment will vary naturally with the 
extent and particular nature of the injury, either 
coming under the head of general surgical principles 
or special operative considerations. One of the com- 
mon results of severe traumatism of the orbital re- 
gion is dislocation of the eyeball, which may or 
may not be a very serious condition, depending 
entirely upon the injury inflicted on the eye itself. 

If the injury is recent, with no laceration of the 
globe or interocular hemorrhage, there is every 
chance of the eye being saved and vision vmimpaired. 
However, in cases where the globe is lacerated, 
cold, or shows evidence of interocular hemorrhage, 
enucleation is the only proper procedure. 

In attempting to replace a dislocated eyeball, the 
chief difficulty encountered is the inversion of the 
eyelids and the swollen condition of the parts. 

The simplest and most efifectual procedure is as 
follows : 

Place the patient in the abdominal position and 
induce a general anesthesia. Have ready for use 
a small scalpel, a small-pointed bistoury, dressing, 
swabs, sterile gauze, fine needles, silk sutures, band- 
age or eye cap, and collodion (all the instruments 
being sterilized by boiling). 

Technic. — The skin around the outer canthus is 

194 



SURGERY OP THE EYE 195 

shaved and disinfected and the eyeball carefully 
cleaned with warm, sterile, normal saline solution. 
An incision about half an inch in length is made 
through the skin at the outer canthus in the same 
direction as the palpebral fissure, thus enlarging it. 

It is now possible to evert the lids, but usually 
it is found impossible to return the eye until the 
orbital sheath, the edge of which can be felt as a 
tense band closely gripping the eyeball, is incised. 
This is done by slipping the probe-pointed bistoury 
between the globe and the sheath, turning the edge 
to the constriction and cautiously dividing it. 

If the lids be now held apart and gentle pressure 
with the palm of the hand applied to the cornea, the 
eye will return quite easily to the orbit and the 
operation is complete. 

The wound at the outer canthus is sutured, dried, 
and sealed with collodion, and a pad of gauze is 
placed over the eye and maintained in position by 
a bandage or eye cap. 

The after-treatment consists in allaying any irrita- 
tion with soothing collyria. 

Warts 

Warts on the eyelids are quite common and 
should be removed by excision, never by ligation, 
as the irritation produced may lead to irreparable 
damage to the eye caused by the patient's endeavors 
to remove the offending ligature with his hind feet. 

Foreign Bodies 

Foreign bodies are a frequent source of trouble, 
the extent of which will vary according to the nature 
of the foreign bodies. These gain entrance to the 
conjunctival sac or impinge on the cornea and as 
a rule give rise to only temporary irritation, which 
quickly subsides upon their removal. Particles of 



196 CANINE MEDICINE AND SURGERY 

metal, thorns, and other sharp objects, which pene- 
trate the cornea, either partially or completely, are 
more dangerous, sometimes leading to ulceration and 
abscess formation which may cause destruction of 
the eye. Larger bodies may so lacerate the cornea 
as to cause evacuation of the aqueous humor and 
collapse of the eye, or may completely disrupt the 
whole ocular apparatus. 

The removal of substances such as eyelashes, dust, 
small pieces of cinder, or metal lodged in the con- 
junctival sac, is best accomplished by first of all 
putting a drop or two of a four-per-cent cocain solu- 
tion into the eye, to diminish sensibility, and then 
everting the lids, locating the foreign body and 
removing it gently with a loop of horsehair. 

Pieces of metal that have stuck onto or into 
the cornea may be removed with fine forceps, the 
eye spud, or with a magnet (if steel or iron). 

If the eye is destroyed, as is usually the case 
when injured by bullets or shotgun ])ellets, enuclea- 
tion should be immediately performed. 

Injuries to the eye by chemicals are not frequent, 
l)ut when occurring are always serious. 

Acids must be neutralized with alkali, and vice 
versa. 

Lime is best rendered harmless by flooding the 
sac with a saturated solution of sugar, as sugar 
neutralizes the corrosive action of lime. The result- 
ing irritation from any cause is to l)e allayed under 
the line of treatment laid down for the varying con- 
ditions produced. 

Entropion 

Entropion, or the turning in oi either the upper 
or lower eyelid, is a congenital condition nearly 
always calling for surgical interference on account 
of the great irritation produced by the eyelashes 



SURGERY OF THE EYE 197 

impinging- on the eyeball. The object sought by 
the operation is the reduction of the superfluous 
skin of the eyelid and the restoration of the lid to 
its normal position. 

The following instruments and dressings are 
sterilized by boiling and laid in sterile water in 
sterile instrument trays : a scalpel, a pair of curved 
scissors, entropion forceps, dressing forceps, needle 
holder, six needles and sutures (silkworm gut), 
swabs, ether, and iodized collodion. 

Place the patient in the abdominal position and 
induce a general anesthesia. 

Technic. — The eyelid is shaved and cleaned in the 
usual manner, and a fold of skin parallel to the 
direction of the eyelid seized with the entropion 
forceps. Care must be taken to pick up skin only, 
and only just enough of it to bring the eyelid back 
to normal. The forceps are then clamped and the 
fold of skin excised with the scalpel or scissors. 

The cut must be made close to the forceps. The 
result is an elliptical Avound, which, when the hemor- 
rhage has been controlled by pressure, is sutured 
by interrupted stitches placed one eighth of an inch 
apart. The wound is then swabbed with ether, 
which is allowed to evaporate, and finally sealed 
with iodized collodion. Sutures are to be removed 
in about six days. 

If neatly executed, and if strict attention is paid 
to asepsis, most excellent results are obtained by 
this operation, and unless infected the wound pro- 
duces no irritation and the patient shows no inclina- 
tion to interfere with it. Should he do so, however, 
an Elizabethan collar should be placed on him to 
prevent him scratching it with his hind feet. 

In addition to the surgical treatment, any irrita- 
tion of the conjunctiva or cornea must be treated 
with mild astringent and antiseptic collyria. 



198 CANINE MEDICINE AND SURGERY 

Ectropion 

Ectropion is the opposite condition to that de- 
scribed above, namely, the turning out of the eye- 
lid, and gives the animal a most unsightly appear- 
ance. The object of operative measures is to restore 
the eyelid to its normal position by shortening the 
lid in its longitudinal direction. This is affected by 
excising a triangle-shaped flap of skin from the 
affected lid, the base of the triangle being parallel to 
the edge of the lid. The technic is the same as for 
entropion, the size of the flap being determined by 
experimental manipulations of the skin of the lid. 

Pterygium 

Pterygium, or dermoid growth on the cornea, is 
generally a congenital condition and consists of an 
outgrowth of the conjunctiva, which covers more 
or less of the sclerotic and cornea. As a rule 
numerous hairs project from it and cause great 
irritation. In some cases the growth is firmly at- 
tached to the underlying tissues ; in others it is 
attached only at its two extremities. 

Operation consists in the careful dissecting ofif of 
the membrane, and is always advisable, owing to 
the irritation produced. The following instruments 
are sterilized and laid ready for use : a Graefe's 
scalpel, fine rat-toothed forceps, eye speculum, and 
swabs of absorbent cotton. 

Place the patient in the abdominal position and 
induce a general anesthesia by H-M-C and chloro- 
form. The operation can be performed with local 
anesthetics, but with increased risk of injury to 
the eye. 

Technic. — The patient being completely under the 
influence of the anesthetic, the operator inserts the 
eye speculum and drops into the eye a few drops 
of adrenalin solution. While the assistant steadies 



SURGERY OF THE BYE 199 

the head, he then seizes the growth at its corneal 
attachment and with the Graefe's scalpel proceeds 
to dissect it off. The blade of the knife must be 
kept parallel with the cornea to prevent injury, and 
moderate tension should be kept on the forceps 
until the growth is finally remeved. Hemorrhage 
is easily controlled by adrenalin solution and mod- 
erate pressure. 

The after-treatment consists in daily cleaning the 
eye with boric-acid solution, until all irritation has 
subsided. 

Displaced Orbital Gland 

In the dog, just beneath the membrana nictitans, 
is situated a little rounded mass of glandular tissue, 
the orbital gland. This gland, as the result of 
traumatism, may become displaced and appear at 
the inner canthus of the eye as a reddish and often 
angry-looking mass which is exceedingly unsightly 
and sometimes produces irritation. While easily 
replaced, it is next to impossible to retain it in posi- 
tion, and surgical interference is the only means of 
removing this eyesore. 

The instruments to be used are blunt-pointed 
scissors, rat-toothed forceps, and dressing forceps. 
Have ready also swabs, an adrenalin solution, and 
a four-per-cent cocain solution. 

Place the patient in the abdominal position and 
apply a local anesthetic of four-per-cent cocain. 

Technic. — After confining the patient in the ab- 
dominal position, a few drops of the cocain solution 
are placed in the lower conjunctival sac, which later 
on is flooded with adrenalin solution. When anes- 
thesia is complete the assistant, who also steadies 
the patient's head, holds the membrana nictitans 
aside with the dressing forceps while the operator 
seizes the gland with the rat-toothed forceps and, 



200 CANINE MEDICINE AND SURGERY 

pulling it out as far as possible, clips it away from 
its attachment with the blunt-pointed scissors. 
Hemorrhage is controlled by adrenalin and pressure, 
and the patient is released. The eye should be 
washed out daily for a week with boric-acid solu- 
tion and the patient not exposed to direct sunshine, 
dust, flies, or strong winds until all signs of irrita- 
tion have disappeared. 

Enucleation of the Eyeball 

This drastic procedure may be rendered necessary 
by varying causes, such as destruction of the eye 
by injuries, suppuration, or new growths invading 
the eye or orbit, or to relieve the patient of the 
persistent pain sometimes attending glaucoma. 

Place the patient in the abdominal position and 
induce a general anesthesia by H-M-C and chloro- 
form. 

Have ready at hand a pair of curved scissors, a 
tissue forceps, two artery forceps, a rat-toothed 
forceps, and two needles and silk sutures, all the 
instruments to be sterilized by boiling and laid in 
sterile dishes filled with boiled water ready for use. 
Dressings, sterile swabs, gauze moistened with ster- 
ile glycerin, adrenalin chlorid solution, an eye 
dropper, an eye cap, and bandage must be ready 
for use. 

Technic. — The patient being properly secured and 
completely under the influence of the anesthetic, 
the operator passes sutures through each eyelid, 
but does not tie them. The assistant keeps the lids 
apart by traction on the sutures during the whole 
of the following stages. The conjunctival mucous 
membrane is then seized with the forceps and but- 
tonholed with the scissors, which are then introduced 
into the wound and the mucous membrance divided 
around the circumference of the orbit. The resulting 



SURGERY OP THE EYE 201 

hemorrhage is controlled quite easily by pressure 
and a few drops of adrenalin solution. The cornea 
is then seized with the rat-toothed forceps and the 
eye pulled out as far as possible. 

The muscles are then divided one by one with 
the scissors close to their sclerotic attachments, and 
finally the optic nerve is divided as far back in the 
orbit as possible. The hemorrhage is slight and 
easily controlled by pressure, ligation being not 
only unnecessary but harmful. The stumps of the 
muscles are then trimmed and shortened, and the 
orbit tamponed with the glycerinated gauze. The 
glycerin prevents the tampon adhering and renders 
its removal the next day easy and painless. 

After firmly packing the orbit the lids are closed 
with the sutures already used in retracting them, 
and a sterile gauze pad is applied over the orbit and 
kept in position with an eye cap or bandage. The 
tampon is removed in twenty-four hours and the 
orbit swabbed out with sterile normal saline solu- 
tion, taking care to remove all blood clots. The 
orbit is then repacked with the glycerinated gauze, 
care being taken to completely fill it so that the 
eyelids are prevented from turning in. 

The orbit must be dressed after this manner every 
day until healing takes place, otherwise the lids 
will turn in from the contraction during the process 
of healing and cause great irritation, in addition to 
introducing infection. 

If careful attention is given to asepsis, pus for- 
mation is either very slight or entirely absent. If, 
however, infection does occur, the orbit should be 
flushed out with a solution of chinosol at each 
dressing. 

After healing is complete, a glass eye may be 
inserted or the patient may be made more present- 
able by the following procedure : 



202 CANINE MEDICINE AND SURGERY 

Under complete anesthesia, and with all aseptic 
precautions, the margins of the lids are denuded of 
their skin and the lids sutured together (blepharor- 
rhaphy). When union is complete and the sutures 
removed, melted surgical wax is introduced into 
the orbit by means of a hypodermic syringe, in suffi- 
cient quantity to produce the appearance of a nor- 
mally closed eye. As the wax cools, it is gently 
kneaded to the proper form. 



SECTION IV 

SURGERY OF THE THORAX AND ABDOMEN 
Paracentesis Thoracis 

^HIS simple and harmless operation is performed 



T' 



for the purpose of removing fluid from the 
thoracic cavity. It may be repeated with perfect 
safety as often as circumstances require, provided 
that rigid asepsis is maintained. 

The patient must be in the standing position, but 
held firmly by an assistant. Apply a local anes- 
thesia of ethyl chlorid spray, and have at hand a 
trocar and cannula, a razor, swabs, and iodized 
collodion. 

Technic. — The point of puncture on either side is 
the intercostal space between the seventh and eighth 
rib. Shave and disinfect an area two inches square. 
Pull the skin backwards and introduce the sterilized 
trocar and cannula into the thoracic cavity, taking 
care to make the puncture midway between the ribs, 
thus avoiding the vessels and nerves. Withdraw 
the trocar, and allow the fluid to flow away. 

A small trocar and cannula must be used, for 
otherwise the evacuation of the fluid is so rapid as 
to produce syncope and sometimes a fatal result. 
There is little danger of wounding the lung, as it 
is floated up and compressed by the fluid and is 
therefore well above the line of puncture. 

In withdrawing the cannula, the fingers should 
press the skin down firmly on either side of it, to 
prevent its separating the skin from the muscles. 
It will be seen that after the cannula is withdrawn 
the puncture in the skin and that in the muscles 

203 



204 CANINE MEDICINE AND SURGERY 

and pleura do not coincide, thus averting the en- 
trance of air through the wound. After withdrawal 
of the cannula the wound is swabbed dry and sealed 
with iodized collodion. 

Paracentesis Abdominis 

PUNCTURE of the abdominal cavity by means of 
a trocar and cannula is necessary for the re- 
moval of the ascitic transudate in cases of abdomi- 
nal ascites or the exudate of chronic peritonitis. 

The operation is harmless provided surgical meth- 
ods are observed, and may be repeated with perfect 
safety as often as circumstances require. 

The patient must be in the standing position, 
held securely by an assistant and muzzled. For 
instruments use a razor, trocar and cannula, and 
probe, and for dressings have ready iodin, swabs, 
and iodized collodion. 

Technic. — Shave and disinfect an area about two 
inches square just posterior to the umbilicus. At a 
point one inch behind the umbilicus introduce the 
sterilized trocar and cannula obliquely through the 
skin for one half an inch, then direct the trocar 
straight upward and press, until the loss of resistance 
indicates that the abdominal wall has been pene- 
trated. Withdraw the trocar and allow the fluid to 
escape through the cannula. Should the flow cease, 
the cannula is probably blocked by the omentum or 
by a clot, and the probe should be inserted and the 
obstruction gently pushed away. In withdrawing the 
cannula the fingers should press against the skin as 
in paracentesis thoracis, and for the same reason. 
After withdrawal, the wound should be swabbed 
with iodin and sealed with the iodized collodion. 

Paracentesis Vesicae 

Puncture of the bladder is rendered necessary 
when that organ is dangerously distended with 



LAPAROTOMY 205 

urine and where it is found impossible or inadvis- 
able to pass the catheter. The operation is simple 
and harmless if proper surgical methods are used 
and should be performed without hesitation when 
conditions indicate it. The point of insertion of the 
fine trocar or hypodermic needle is directly anterior 
to the brim of the pelvis in the middle line in the 
bitch and just to one side of the penis in the dog. 
The operative area is shaved and disinfected as 
usual and the trocar, cannula, or hypodermic needle 
sterilized by boiling. The patient should be in the 
standing position, owing to the danger of rupturing 
the bladder during the struggling incident to being 
laid on the table. 

Laparotomy 

Laparotomy, or abdominal section, is the prelude 
to many surgical manipulations of the abdominal or 
pelvic organs. It is classed among the major opera- 
tions, but thanks to. aseptic surgery it has now lost 
most of its former terrors and dangers. 

The incision should be made in the linea alba in 
the long axis of the body, directly over the organ 
it is desired to remove or subsecjuently operate on. 
By the middle-line incision hemorrhage is avoided, 
the mammary glands in the case of the bitch are 
not interfered with, and the scar is scarcely noticed 
a month or so after operation. Complete surgical 
anesthesia is essential, otherwise the omentum or 
intestines are liable to protrude through the wound 
and seriously handicap the operator, besides increas- 
ing an hundred-fold the ri.sk of that hete noir of ab- 
dominal surgery — infection, with its sequelne of peri- 
tonitis and death. 

The animal should be in the dorsal position, then 
general anesthesia induced by H-M-C and chloro- 
form. The instruments used, scalpel, razor, dress- 



206 CANINE MEDICINE AND SURGERY 

ing forceps, artery forceps, and grooved dissector, 
should all be sterilized by boiling, and swabs, iodin, 
gauze and wool dressing, bandages, and boiled water 
be ready for use. 

Technic. — Wash and shave the entire abdomen 
and disinfect as usual. With the scalpel make an 
incision the necessary length and exactly in the 
middle line through the skin, subcutis, and linea 
alba down to the peritoneum. Control hemorrhage. 
Incise the peritoneum, being careful not to wound 
the intestines or other organs, introduce the dis- 
sector, and sliding the back of the knife along the 
groove, slit the peritoneum open for the length of 
the wound required for further manipulation and 
proceed with whatever the abdominal section was 
performed for. 

The wound should be closed with interrupted silk 
or silkworm-gut sutures, taking care to include all 
three layers of the abdominal wall; that is, the peri- 
toneum, the muscles, and the skin. 

The edges of the wound should be grasped with 
the dressing forceps while inserting the sutures, and 
care taken to prevent the latter from touching the 
body during inaction. Touch the wound only with 
sterilized instruments to avoid infection. When the 
sutures are all placed, tie them and swab ofif the 
wound with boiled water, then dry it with a sterile 
swab and apply the sterile gauze dressing and 
bandage. 

Remove dressing in three days and inspect the 
wound. If it is dry and aseptic, dress again with 
sterile gauze and leave undisturbed for three days, 
when the sutures should be removed. If at the first 
inspection it is found that infection has occurred, 
the wound must be cleaned with hydrogen peroxid, 
dried, painted with tincture of iodin, and redressed 
with a sterile gauze dressing. The wound must then 



GASTROTOMY 207 

be dressed daily and the sutures removed' in five or 
six days. 

Diet. — Subsequent to laparotomy the diet must 
be wholly liquid — milk, beef tea, or beef juice. Raw 
or cooked meat may be allowed, but no bones or 
large pieces of meat, bread, or biscuit must be given 
for at least two weeks after the operation. 

Nursing. — After the operation the patient should 
be confined in a perfectly clean kennel, be perfectly 
quiet, and be prevented from jumping, and ascend- 
ing or descending stairs. A plentiful supply of 
clean, cold water should be constantly provided. 

The temperature should be taken night and morn- 
ing and recorded on a chart, as well as the condition 
of the bowels and urine. 

Gastrotomy 

Incision of the stomach in canine patients is 
chiefly performed for the removal of foreign bodies 
either in the stomach itself or in the lower part of 
the esophagus. 

Preparation. — Perform laparotomy, the incision be- 
ing made in the middle line, commencing about two 
inches posterior to the xiphoid cartilage and extend- 
ing backward. The additional instruments and ma- 
terials required will be a scalpel, long slender forceps, 
ten round milliner's needles. No. 8 or No. 9, threaded 
with No. 2 size black sewing silk, the thread being 
tied into the eyes. Also have ready a needle holder, 
gauze and a piece of rubber sheeting ten inches 
square, having a slit three inches long cut in the 
center. 

Technic. — The stomach is located and pulled up 
through the slit in the rubber sheeting, which is 
laid over the abdomen. The stomach is then care- 
fully packed around with gauze so as to eliminate 



208 CANINE MEDICINE AND SURGERY 

the possibility of any of its contents entering the 
abdominal cavity. 

The foreign body is then pressed up against the 
stomach wall and an incision made directly over it 
and large enough for its removal, x^fter the re- 
moval of the foreign body, the edges of the wound 
in the viscus are swabbed off with sterile water 
and sutured closely with the black sewing silk, using 
the Czerny-Lembert suture.* If the foreign body is 
located in the lower part of the esophagus the pro- 
cedure is as follows : Make an incision into the stom- 




Czerny- Lembert Suture. 

ach, introduce the long forceps as far as the for- 
eign body, and extract it through the stomach 
wound, which is then sutured as before described. 
After suturing, the stomach is carefully cleaned off 
and replaced in the abdominal cavity. The lapa- 
rotomy wound is closed and treated in the same 
manner as described for that operation. Rectal 
feeding must be kept up fur at least a week, and 
fluid food only allowed by tlic mouth for another two 
weeks after the operation. 

*A combination of Czerny's and Ijeniliei-t's sutures in circular 
enteronhaplny; named for Vincent Czerny, a Heidelberg surgeon, 
born in 1842, and Antoine Leml)ert ( 1S02-1S.51), a French surgeon- 



SURBERY OF THE INTESTINES 209 

Enterotomy 

Incision of the intestines is performed for the pur- 
pose of removing foreign ])oclies or fecal accumu- 
lation. 

Preparation. — Perform laparotomy, using the same 
instruments and materials listed and the same tech- 
nic as for that operation and gastrotomy. 

Technic. — The intestine with the foreign body is 
located and pulled up in the same manner and with 
the same precautions as is the stomach in gastrotomy. 

Make an incision and extract the foreign body, 
clean up the bowel, and suture with Czerny-Lem- 
bert sutures, taking care to invaginate the edges of 
the bowel so as to bring the peritoneal surfaces 
together. 

Enterectomy and Intestinal Anastomosis 

In many cases of injury or gangrene of a portion 
of the intestines excision of a section of the bowel 
and anastomosis of the cut ends (enterorrhaphy) is 
often the only chance of saving the patient's life. 
To insure any chance of success, the operation must 
be performed before the onset of peritonitis and 
utter exhaustion of the patient. 

Preparation. — Perform laparotomy, using the tech- 
nic for that operation. 

Have ready a scalpel, scissors, twelve No. 8 or No. 
9 milliner's needles, twelve black sewing silk sutures. 
No. 2, tied into the eyes of the needles, a needle 
holder, six ligatures, No. 2 black sewing silk, two 
pairs of artery forceps, a pair of wire cutters, two 
hairpins, a piece of rubber sheeting ten inches scjuare 
with three-inch slit cut in center; gauze, swabs, 
and so on. 

Needless to say, all the above must be perfectly 



210 CANINE MEDICINE AND SURGERY 

sterile, and the utmost care taken to maintain asepsis 
throuirhont the entire proceeding-. 

Technic. — Dr. French's method, the simplest and 
the one giving the most satisfactory results, is as 
follows : The affected portion of the bowel is pulled 
up out of the wound and through the slit in the 
rubber sheeting, and surrounded with the sterile 
gauze. The operator must then carefully investi- 
gate the local blood supply and determine which 
mesenteric vessels can be ligated without danger 
of obliterating the blood supply to other than the 
part of the intestine to be removed. The branches 
that supply that portion are then ligated with fine 
silk. 

One prong of the hairpin is then passed through 
the mesentery at the upper point of resection, and 
both are brought transversely across the gut. The 
other pin is placed in the same manner at the lower 
point of resection. Both pins are clamped at their 
free extremities with artery forceps, thus completely 
obliterating the lumen of the bowel. The intestine 
is then severed with the scapel, quite close to the 
clamped prongs of the pin, the incision being ex- 
tended to the mesentery so as to remove a wedge- 
shaped portion of it. The two pins are approximated 
and tied tightly together. 

Halsted sutures are then placed, starting at the 
mesenteric attachment. Care must be taken that the 
margins are properly turned in so as to bring the 
peritoneal surfaces together. Next, the bowel is 
turned over and the other side sutured in the same 
manner. The pins are then untied and undamped, 
severed at their bent ends with the wire cutters, 
and withdrawn, one prong at a time. The remaining 
four openings are closed with one stitch each. 
Finally the incision in the mesentery is closed by a 
continuous suture. 



SPAYING 211 

Rectal feeding must be maintained for the first 
week. Then milk, beef tea, or very finely chopped 
meat for two weeks, after which the ordinary diet 
may be allowed. 

Ovariotomy and Ovariohysterectomy 

The objects of these operations are either to pre- 
vent pregnancy or to remove a diseased ovary or 
uterus. The most favorable age, where sterilization 
is the object, is from six to twelve months. 

Preparation. — First perform laparotomy as hereto- 
fore directed, making the incision just posterior to 
the umbilicus and extending backwards for about one 
ard one-half inches. 

Technic. — Elevate the table so that the hind quar- 
ters are raised considerably. This allows the viscera 
to slide forward out of the operator's way. With 
the retractors (blunt aneurysm needles answer 
most admirably), pull the abdominal wound open, 
locate the cornua of the uterus by sight, and seize 
one of them with the forceps. Elevate the ovary by 
pulling on the horn, place a ligature of aseptic silk 
above and below the ovary, and excise with the 
scissors. Remove the other ovary by the same 
method, and close the laparotomy wound and dress 
as described previously. It will be noticed that at 
no stage of the operation are the operator's fingers 
introduced into the abdominal cavity, and that the 
intestines are not manipulated in any way. 

In ovariohysterectomy, after locating the cornua, 
the uterus and ovaries are pulled up into the wound 
and the uterus ligated at the bifurcation, taking 
care to include the utero-ovarian arteries. Ligatures 
are then placed below each ovary, which are clipped 
away from their pedicles with the scissors. The 
broad ligament is then stripped away from the horns 
with the fingers and the uterus amputated anterior 



212 CANINE MEDICINE AND SURGERY 

to the ligature. In this manner the ovaries and 
cornua are removed in their entirety, with practically 
no hemorrhage or risk of infection. 

Hysterotomy — Cesarean Section 

The object of this operation is the removal of 
live or dead fetuses. This operation, to be success- 
ful, must be performed suf^ciently early and is pref- 
erable to, and offers better chances of recovery to 
the mother, than prolonged or forcible manipulation 
with the forceps. 

Preparation. — Perform laparotomy, making the 
incision in the median line extending backwards 
from an inch behind the umbilicus to about an inch 
anterior to the brim of the pelvis. If the bladder is 
full, evacuate the urine by puncture with a sterile 
hypodermic needle or pass the catheter. Use the 
same instruments and materials as for gastrotomy. 

Technic. — Bring the uterus well up into the wound,. 
l)locking it off from the peritoneal cavity with sterile 
gauze wrung out in warm, sterile, mnmal saline solu- 
tion. Make an incision in the long axis of the horn 
and as close to the fundus as practicable, and extract 
the fetuses, all through the same incision. 

Care must be taken not to incise or rupture the 
fetal membranes, as the risk of infection is thereby 
enormously increased. The best plan is for the 
operator to manipulate the fetuses into the uterine 
wound. Then the assistant extracts them and hands 
them as they are delivered to a second assistant, 
who looks after them. In this way the operator 
does not get his hands contaminated by coming in 
contact with the interuterine fluids. The after-births 
should then all be removed and the uterus swabbed 
out with normal saline solution. The uterine wound 
is sutured with No. 2 size black sewing silk, using 



LITHOTOMY 213 

the Czerny-Lemljert or Halsted suture. The ab- 
dominal wound is closed in the usual manner, with 
interrupted sutures. 

The dangers from this operation are infection, with 
all its attendant sequelae and shock. These dangers 
are vastly increased if the fetuses are dead and de- 
composed. In cases where the fetuses are dead and 
the uterus shows signs of gangrene, or it is decided 
that the bitch is not to be used for breeding again, 
ovariohysterectomy should be performed in prefer- 
ence to hysterotomy. 

The technic here ditters slightly from a simple 
case of hysterectomy. The blood supply of the preg- 
nant uterus is greatly in excess of the resting one, 
and the first. step is to ligate both utero-ovarian and 
uterine arteries. Ligatures are placed as for simple 
ovariohysterectomy, with the exception that the 
fundus of the uterus is ligated just behind the bifur- 
cation and clamped about one inch posterior to the 
ligature. 

The uterus is then divided between the ligature 

UTERUS WITH CUT END M 

INVAGINATED & SUTURED V| 

and the clam.p, the broad ligament broken dowii 
and the cornua, with their contained fetuses, and 
the ovaries removed. The stump of the uterus is 
then carefully cleaned and invaginated and sutured 
with a purse-string suture. Unless this latter step 
is taken peritonitis almost invariably follows, as it 
is quite impossible to completely disinfect the uter- 
ine stump. 

Suprapubic Lithotomy 

The object of this operation is the removal of a 
vesical calculus. 



214 CANINE MEDICINE AND SURGERY 

Preparation. — Perform laparotomy in the median 
line in the bitch, to one side of the penis in the dog, 
the incision extending forward from the brim of the 
pelvis. 

Technic. — Bring the bladder up into the wound, 
incise it, and extract the calculus. Suture the vesical 
wound with two rows of Czerny-Lembert sutures, 
taking care not to suture the mucous membrane. 
Close the abdominal wound as in laparotomy. 



SECTION V 

OPERATIONS FOR HERNIA 

HERNIA consists of the protrusion of an organ 
or portion of an organ out of its normal posi- 
tion, through an opening in the surrounding tissues. 
The varieties most commonly seen in the dog arc 
umbilical, ventral, and inguinal. Scrotal, femoral, 
and perineal hernias are much more rare. 

The main principles of treatment are the same in 
all cases and consist in the return and retention of 
the organs to their normal position. 

The instruments required include two scalpels, 
two pairs of artery forceps, two pairs of dressing 
forceps, scissors, probe-pointed bistoury, grooved dis- 
sector, needles and sutures, small trocar, and needle 
holder. Have ready also swabs, iodin, iodized col- 
lodion, gauze, dressings, and bandages. 

Place the patient in the dorsal position and induce 
general anesthesia by the use of H-M-C and chloro- 
form. 

Umbilical Hernia 

This condition consists of a swelling at the um- 
bilicus. It may be soft, fluctuating, and easily 
reducible, or it may be irreducible because of ad- 
hesions or because the umbilical ring has contracted 
since the mass was extended. In the latter case it 
feels hard to the touch and contains only omentum. 

It is dangerous because strangulation may occur 
and lead to fatal peritonitis. 

Technic. — The skin is shaved and disinfected in 
the usual manner and the instruments sterilized. 
Make an incision over the center of the swelling 

215 



216 CANINE MEDICINE AND SURGERY 

through the skin only. Return the contents of the 
sac, being careful to break down all adhesions. 
Scarify the edges of the umbilical ring and draw 
them together with silk sutures. The skin is then 
sutured with silkworm gut or silk, the wovuid dried, 
and sealed with iodized collodion. 

Ventral Hernia 

Ventral hernia is usually the result of some injury 
that has lacerated or ruptured the subcuticular tis- 
sues, thus allowing some of the internal organs to 
protrude. It may also occur as a sequel to lapa- 
rotomy, due to want of care in suturing. 

Technic. — After the usual precautions have been 
taken for the maintenance of asepsis, make an in- 
cision through the skin down to the sac (peritoneal 
covering). Incise the sac, and return the contents 
to the abdomen, enlarging the • hernial opening if 
necessary to efifect this. Trim off the superfluous 
sac and after refreshing the edges of the muscles, 
place two rows of sutures. The deep row, of cat- 
gut, must include the peritoneum and muscular 
layers ; the upper, of silk, closes the skin wound. 
After drying the wound, seal with collodion and, 
if necessary, support with a sterile pad of gauze 
and a bandage. In large rents of the abdominal 
wall, where there is risk of prolapses, a Bayer suture 
and dressing should be placed in addition to the 
simple suturing. 

Inguinal Hernia 

Inguinal hernia is more common in bitches than 
in dogs, and commoner in multipara than in maidens. 
As a rule the contents of the sac contain one or 
both cornua of the uterus, and frequently include 
intestine and omentum in addition. 

Technic. — After thoroughly disinfecting the opera- 



HERIA OPERATIONS 217 

tive area and inducing complete anesthesia, make 
an incision through the skin over the hernial sac, 
pick the sac up with the forceps, and carefully 
incise it without wounding its contents. Break down 
any' axlhesions, and return contents to the abdomen. 
Seize the extremity of the sac with a pair of artery 
forceps and twist the sac until it forms a sort of 
pedicle, and around this place an aseptic silk liga- 
ture. Cut off the lower portion of the sac, suture 
the external wound, dry, and seal with the iodized 
collodion. 

« At times it is found necessary to enlarge the in- 
ternal ring before reduction is possible. This must 
be done with great caution with the probe-pointed 
bistoury or proper hernia knife, always remembering 
that the external pudic vessels and nerves are situ- 
ated toward the middle line and pass through the 
ring. 

Scrotal Hernia 

Scrotal hernia manifests itself as a soft, fluctuat- 
ing, painless, and usually reducible swelling in the 
scrotum, the reduction being accompanied by a 
gurgling sound. 

Technic. — Disinfect the scrotum and anesthetize. 
Reduce the hernia, make an incision in the long axis 
of the scrotum down to the tunica vaginalis testis, 
and separate the latter from the surrounding tissues. 
Pull the testicle down and ligate the cord as high 
as possible above the ligature. Remove the testicle, 
leave the scrotal wound open, and treat antiseptically. 

Perineal Hernia 

This occurs as a soft swelling at the side of the 
anus. The herniated organs are usually omentum 
or bowel and the bladder. 

In the latter case the condition is dangerous, as 
the bladder is twisted on itself and retention of urine 



2^i CANINE MEDICINE AND SURGERY 

a common sequence. It is often associated with 
neoplasms on the neck of the bladder, and enlarge- 
ment of the prostate gland. 

Operation. — Disinfect the area and anesthetize. If 
the bladder is herniated, evacuate the contents by 
puncture with fine trocar and cannula. Cut down 
on to the hernial sac and return the contents to the 
abdomen. Break down all adhesions, seize the sac 
with the forceps, twist into pedicle and ligate, and 
ablate remainder of sac. 

Remove superfluous skin and suture with inter- 
rupted sutures, dry, and seal with collodion. As 
soon as the patient has recovered from the opera- 
tion, perform laparotomy, replace the bladder (if this 
was the herniated organ), and stitch it to the ab- 
dominal wall with three sutures, which must pene- 
trate only the muscular wall of the bladder. 

Femoral Hernia 

The technic for the operation on femoral hernia 
is the same as for inguinal hernia, but due regard 
must be paid to the proximity of the femoral ves- 
sels, since the hernia descends through the crural 
ring. 



SECTION VI 

SURGERY OF THE LEGS AND TAIL 
Sprains 

SPRAINS of the muscles and articulations are 
commonly the result of injury sustained by fall- 
ing from a height, sudden turns, and injuries met 
with while jumping. The symptoms are pain, heat 
and swelling of the part affected, and complete or 
partial loss of function. 

• Treatment consists of enforced rest and, where 
possible, of immobilization of the injured member. 
To subdue the acute inflammatory condition, cold 
applications should be applied and frequently re- 
peated ; later hot fomentations and gentle massage 
should take the place of the cold packs and a mild 
liniment gently rubbed in or the parts painted with 
tincture of iodin. 

Dislocations 

Dislocations occur as the result of violent wrench- 
ing of a joint and are generally sustained while run- 
ning, jumping, or falling from a height. The symp- 
toms are swelling at the joint, shortening of the 
limb, and imperfect movement attended with great 
pain. The most common dislocations met with are 
those of the shoulder, elbow, stifle, and toe joints. 

Since dislocations, wherever situated, can always 
be diagnosed by palpation and manipulation, and 
confirmed by the X-ray if necessary, only the prin- 
ciples of treatment will be given here and no space 
taken up with a consideration of any possible con- 
dition. 

Treatment should be adopted as soon as possible 

219 



220 CANINE MEDICINE AND SURGERY 

after the injury has occurred. Place the patient 
under a general anesthetic to relax the muscles and 
so faciliate reduction. By palpation or, if available, 
by the X-ray determine exactly the condition to be 
dealt with and then think out the manipulations 
required to reduce the joint to its normal position. 
When successful, the bones often go back into place 
with a distinct snap and the deformity of the joint 
disappears. After reduction, the whole extremity 
should be placed in a plaster bandage. When the 
dislocation occurs in the shoulder, hip, or stifle, 
where it is impossible to apply a bandage, the parts 
may be more or less immobilized by first of all 
clipping the hair, applying fish glue to the skin, and 
then pieces of book muslin, layer on layer, using the 
glue as frequently as required, until about a dozen 
thicknesses of the muslin have been applied. This 
glue cast sets very hard, is light, and supports the 
parts nicely. It is easily removed by soaking in 
warm water. 

Dislocation of the tail is generally met with in 
greyhounds, whippets, or in dogs having a long 
tail. If seen sufficiently soon after injury the dis- 
location is easily reduced. The tail should be kept 
in place either by a glue bandage or adhesive plaster. 

Necrosis 

Necrosis of the caudal vertebra is frequently met 
with and in advanced cases necessitates amputation 
of the tail. The condition is the result of injury, 
such as a bite from another animal, or the tail be- 
ing run over, jammed in a door, or trodden upon. 

The symptoms of necrosis are a swelling in the 
affected region, tenderness and ajjscess formation. 
The treatment consists of free incision, the removal 
of sequestra, and free curettage. After operation 



AMPUTATION OF THE TAIL 221 

the wound should be treated with tincture of iodin 
until healed. 

Amputation of the Tail 

Amputation of the tail may be performed by two 
methods: (1) circular incision through the skin mus- 
cles and vertebral joint ; (2) the flap operation. 

Amputation by Circular Incision. — Place the pa- 
tient in the abdominal position, and have ready hair 
clippers, large scalpel, tape, gauze, bandage, and 
tincture of iodin. Clip the hair from the tail and 
paint with tincture of iodin. Pull the skin back 
toward the root of the tail and tie a piece of tape 
tightly round the tail, close to the body. Locate a 
joint, and with one cut of the scalpel sever skin 
'muscles and articulation. Paint with iodin, apply a 
gauze dressing, and bandage. Remove the tape in 
eight hours and pull the skin down over the stump. 
Disinfect daily until healed. Healing occurs by 
granulation. 

The Flap Operation. — This is the more surgical 
method and is to be preferred in old dogs and in 
the large breeds. Place the patient in the abdominal 
position and induce general anesthesia by H-M-C 
and chloroform. For instruments and materials have 
ready a scalpel, razor, scissors, artery forceps, needles 
and sutures, tape for tourniquet, gauze dressing, and 
bandage swabs, all to be sterilized by boiling. 

Technic. — The tail is to be shaved and disinfected 
in the usual manner. Form two flaps by semi- 
elliptical incisions and dissect them away from the 
bone back to the next joint. Disarticulate the joint, 
pick up and twist the arteries, and suture the flaps 
together. Dress with gauze, and bandage! Remove 
the tourniquet in eight hours. 



222 CANINE MEDICINE AND SURGERY 

Fractures 

Fractures are termed simple when there is no ex- 
ternal wound ; compound, when the broken ends of 
the bone protrude through the skin ; comminuted, 
when the bone is shattered into fragments ; and com- 
plicated, when serious damage has been done to 
neighboring tissues, organs, vessels, or nerves. 
Greenstick fracture is the term applied to the bend- 
ing and only partial fractures seen in young animals 
whose bones are more or less plastic. The symp- 
toms of a fracture are pain, inability to support 
weight, and crepitus. 

Reduction. — Besides being more humane, it ren- 
ders the necessary manipulations simple and more 
efifectual to reduce a fracture under the influence of 
a general anesthetic. An additional advantage of 
anesthetization, especially where H-M-C is used, is 
that the casts used to retain the fracture have time 
to harden before the patient comes out of the anes- 
thetic. Reduction is effected, and the ends of bone 
brought into apposition, by grasping the limb firmly 
with one hand, above the fracture, and bringing the 
lower portion into position with the other hand. 
The limb should then be bandaged, starting at and 
including the foot. The bandage is to prevent chaf- 
ing and swelling from unequally divided pressure. 
A plaster of Paris bandage should now be rolled on 
the whole length of the limb, about three thicknesses 
being applied. The limb should be held straight 
until the cast dries, or a splint of cardboard, bass- 
wood, or poroplastic felt applied and bandaged on, 
and left there until the cast is hard. 

With a compound fracture, the wound must first 
be thoroughly cleaned and disinfected, the fracture 
reduced, and a cast applied as in simple fracture, 
but a window must be left for access to and dress- 



AMPUTATION OF CLAWS 223 

ing of the wound. This window may be formed by 
placing a pill-box lid over the wound when bandag- 
ing and applying the cast, afterwards removing it 
by cutting out the parts above with scissors. The 
wound must be dressed every day and a dressing 
applied. 

Fractures of the hip, shoulder, and pelvis are 
treated in the same way as described under disloca- 
tions. Limitation of exercise by confinement in a 
small kennel is the prime factor in the successful 
treatment of this class of fracture. 

Unfavorable terminations to be feared are: 

1. The limb may not be straight. This happens 
if the patient attempts to bear weight on it before 
the cast is properly hardened, or if the cast is re-^ 
moved too soon. 

2. The formation of a false joint, imperfect union 
only taking place and ossification not complete. 

3. Gangrene, owing to severe injury to the main 
blood supply or to pressure from too tight a band- 
age. A fetid smell from the bandaged leg and con- 
tinual uneasiness and attempts at licking on the part 
of the patient give rise to suspicion of this condi- 
tion and the bandages should at once be removed 
and the parts treated antiseptically. 

4. Chafing of the tissues, from rubbing on the 
hard edges of the cast. This may be obviated by 
proper padding and rolling over the edges of the 
cast. 

5. Septicemia, in the case of compound fractures. 

Amputation of Claws 

Amputation of claws is often rendered necessary 
owing to their becoming torn or injured. Where 
there is no bony attachment they may be simply 
snipped off with a pair of strong scissors, the result- 
ing wound being afterwards treated antiseptically. 



224 CANINE MEDICINE AND SURGERY 

When there is a distinct bony union, however, the 
parts must be shaved and disinfected, the skin in- 
cised, and the bone cut through with bone forceps. 
The wound is then sutured and sealed with iodized 
collodion. 

Interdigital Cysts 

These cysts cause considerable lameness and irri- 
tation. The symptoms shown are that the patient 
is continually licking or nibbling at the affected 
spot between the claws, and is more or less lame. 
Examination reveals redness of the part and a bleb- 
like swelling, which is tense and fluctuating, and 
generally painful to the touch. 

Incise the cyst freely and destroy its walls by 
vigorous curettage with a sharp curette. Paint 
the affected part daily with tincture of iodin until 
healed. 

Tumors 

Tumors occur on any part of the body, and are 
classified according to their histology. Their de- 
scription, varieties, and so on, belong entirely to the 
realm of pathology, therefore the reader is referred 
to the textbooks treating that special branch of 
medical science. 

The only effectual treatment of tumors is excision, 
and since tumors vary in size, shape, and position, 
only general principles can be laid down for their 
removal. These are, maintain asepsis, ligate blood 
vessels immediately, regulate the skin so that no 
pockets are left, provide for drainage, and treat 
wound as usual. 



SECTION VII 



OBSTETRICS 



PARTURITION, and the diseases and accidents 
incident to the puerperal condition, belong to 
the general subject of obstetrics. 

The period of gestation in the bitch is sixty-three 
days, or thereabout, and the act of parturition is 
usually accomplished without assistance ; in fact, in- 
terference, except in the case of mal-presentations, 
unduly protracted labor, or some abnormal condition, 
is to be strictly avoided. The motto, "make haste 
slowly," is most applicable here, since even in a 
perfectly normal, healthy bitch labor may be ex- 
tended over a considerable period of time. Unwar- 
ranted interference is always liable to be followed 
by disastrous results. 

The symptoms of approaching parturition are con- 
siderable enlargement of the mammae and of the 
external genitals ; a glairy discharge from the vulva, 
of which the mucous membrane, as well as that of 
the vagina, is of a purplish-red color. Urination is 
frequent and the bitch is restless, constantly seeking 
a place which to her is the most suitable and se^ 
eluded in which to bring forth her young. 

A large, roomy, clean, dry kennel, or for a small 
bitch a large box, should be provided and the bitch 
placed therein as soon as labor begins, otherwise 
she is liable to hide away in some more or less in- 
accessible place, rendering observation and any nec- 
essary help difficult or even impossible. As regards 
bedding, there is nothing better, more cleanly, or 
less liable to interfere with either the bitch, pups, 

225 



226 CANINE MEDICINE AND SURGERY 

or attendant, than a newspaper laid flat. It is easily 
removed and burned after parturition, and may then 
be advantageously replaced with hay, straw, or ex- 
celsior. 

A box or basket lined with flannel must also be 
provided for the pups, which should be placed there- 
in as soon as born, covered with a piece of flannel, 
and not returned to the mother until the last one 
has arrived and the kennel or box has been cleaned. 
They may then be placed with the bitch, which will 
in a normal case clean them and attend to them as 
her instinct prompts her. 

In any case of parturition a certain routine should 
be practiced, otherwise accidents or untoward 
sequelse are liable to result. After disinfecting the 
hands and cleaning the external genitals and vagina, 
a digital examination should be made and the follow- 
ing points noted, — the condition of the os uteri, the 
presentation of the fetus, the size of the pelvic open- 
ing, and the existence or otherwise of maternal mal- 
formation, new growths, or constrictions of the 
vagina. 

The importance of this early examination for the 
discovery of abnormalities cannot be overestimated, 
since the attendant's whole mode of action depends 
upon it. For example, it is useless to expect a 
natural delivery if the pelvic outlet is excessively 
narrow, either by reason of congenital malformation 
or from a previous fracture, and a practitioner who 
allowed labor to proceed until the mother was ex- 
hausted and moribund before he discovered it would 
lay himself open to charge of malpractice. At least, 
he would lose his patient and his client. Too much 
stress cannot be laid upon the use of antiseptic pre- 
cautions, both in making examination and in any 
manipulation required. The hancTs viust be disin- 
fected thoroughly, the instruments must be sterilized 



OBSTETRICS 227 

by hoiliny (laying them in antiseptic solution for u 
few minutes will not sterilize them), and the hind 
quarters of the patient must be washed repeatedly 
with an antiseptic solution. The vagina and uterus 
in the parturient bitch are highly susceptible to' 
septic infection, and every efifort must be exerted to 
avoid infecting them. 

In normal parturition the pups follow one another 
at irregular intervals varying from a few minutes to 
^several hours, so that delay, unless the mother is 
exhausted, the fetus dead, or the pains continuous 
and without result, need not cause alarm or be 
thought to demand interference. If, however, the 
mother is exhausted or the pains weak or unpro- 
ductive, an examination must be made, malpresenta- 
tion corrected, if present, and stimulants — brandy or 
Avhisky combined with from one-fourth to one dram 
of fluid extract of ergot — given every half hour. 
Pituitrin has recently achieved great popularity as 
an agent for inducing contractions of the uterus in 
parturient animals. The dose is from one to four 
drams until delivery is effected or further measures 
required. 

Let me here caution against undue haste in re- 
course to forceps, more bitches having been de- 
stroyed by the incautious use of forceps than there 
have been pups delivered with them. Remember 
always that the slightest laceration is an open door 
,-for the entrance of infectious germs, and that sep- 
ticemia only too often follows such laceration. 

The placenta is usually expelled soon after the 
birth of the fetus, the mother severing the cord with 
her teeth and, generally, eating placentas and mem- 
branes. The placentae should be counted, as retained 
placentae are a fruitful source of septic poisoning. 
After the birth of the last pup the bitch should be 
cleaned and given clean bedding, as heretofore de- 



228 CANINE MEDICINE AND SURGERY 

scribed. She should then be given a hot meal, such 
as gruel, beef tea, or bread and milk, and should 
thereafter be supplied with a generous diet. 

Dystocia 

Impediments to delivery may arise from two 
sources, either maternal or fetal. The table below 
shows the kinds of dystocia that occur in each class: 

MATERNAL 

1. Malformations of the pelvis, congenital or traumatic. 

2. Rigid pelvis. 

3. Constrictions of the vagina. 

4. New growths of cervix, os, or vagina. 

5. Uterine inertia. 

6. Hernia of the uterus. 

7. Torsion of the uterus. 

FETAL 

1. Malformations. 

2. Malpresentations. 

3. Abnormal size. 

4. Hydrocephalus. 

5. Gaseous distension (dead fetus). 

6. Engagement of two puppies simultaneously. 

Dogs with elongated heads, such as greyhounds, 
spaniels, and collies, traverse the maternal passage 
with greater readiness than those with squarer, 
blunter heads, such as bull dogs, Boston terriers, 
and pugs, because with the latter there is not the 
gradual dilatation of the parts that takes place with 
the former class. However, although difficulty in 
delivery is often experienced with the short-nosed 
dogs, yet the conformation is normal and cannot 
therefore be rightly classed as fetal dystocia. 

Maternal Dystocia 

1. Pelvic malformation. — This may be congenital 
or the result of a previous fracture or of disease 
(rachitis). In either case it must be determined 
whether delivery per naturam viam can take place 



OBSTETRICS 229 

or not, and this must be decided at the onset of 
labor or after the preliminary examination. There 
are two courses open to the surgeon, one to endeavor 
to extract the fetus after crushing the head or per- 
forming embryotomy; the other, which gives by far 
the best results if done early enough, is cesarean 
section. This operation, if performed before the 
mother is moribund or septic infection has taken 
place, is justified by its success. The puppies in 
any event are saved, and the mother is given her 
only chance for life. It is as well to remove the 
ovaries ' at the time of cesarean section and thus 
effectually prevent a recurrence of the trouble. 

2. Rigid pelvis. — In old bitches that have been 
kept from breeding until late in life relaxation of 
the pelvic ligaments and consequent dilatation does 
not take place as readily as in the young animal, 
hence difficulty in delivery is often experienced. The 
indications for management are the same as for the 
foregoing. 

3. Constrictions of the vagina. — This condition 
arises from cicatricial contractions after injuries to 
the vaginal mucous membrane, usually incurred 
either during a previous parturition or as a result of 
operations for the removal of new growths or ab- 
scesses. It often is a serious and sometimes an in- 
surmountable obstacle to delivery and may necessi- 
tate cesarean section. Before resorting to this, 
however, a cautious effort should be made to dilate 
the passage either with the fingers or with a trivalve 
speculum ; or one may even try incising it, if its 
situation and extent warrant such a procedure. In 
many cases, however, the fetus may be extracted, 
after thorough lubrication with sterile vaselin or 
olive oil, by means of the forceps and traction 
cautiously applied. 

4. New growths of the os, cervix, and vagina. — 



230 CANINE MEDICINE AND SURGERY 

The most common new growths in the vagina are 
pedunculated fibromata and the infectious granulo- 
mata. If they are at all extensive they constitute 
a mechanical obstacle to delivery. New growths in- 
volving the OS uteri and cervix are of rather rare 
occurrence, but when present are usually malignant. 
Cesarean section to save the puppies, with subse- 
quent extirpation of the entire uterus or destruction 
of the bitch, is the only alternative. 

Pedunculated tumors in the vagina should be re- 
moved with the ecraseur and sessile tumors with the 
scalpel and curette, hemorrhage being controlled by 
pressure and styptics. 

5. Uterine inertia. — This condition is one of the most 
common and at the same time the most vexatious 
with which the practitioner has to deal. It is most 
commonly found in highly bred, overly fat, pam- 
pered, or debilitated bitches. The uterine contrac- 
tions become weak or entirely suspended after the 
birth of one or two puppies, sometimes even before 
the first one is delivered. It is the cause of great 
mortality, as the unborn puppies quickly die and 
decompose. The bitch must be given stimulants — 
brandy or whisky orally and ergotin hypodermically, 
or fluid extract of ergot orally every thirty minutes 
until the contractions begin again. 

If ergot fails, large doses of quinin sulphate com- 
bined with intrauterine injections of warm sterilized 
glycerin will often have the desired effect. One to 
four drams of pituitrin, repeated in one hour if 
necessary, is a remedy for this condition that gives 
much promise, but its usefulness is not yet positively 
decided. In any event, treatment must be persistent 
and continuous until the contractions are reestab- 
lished. It is not only useless but bad practice to 
fish around with the forceps and try to remove the 



OBSTETRICS 231 

fetus by force unless it is well into the vagina. Such 
procedure only leads to lacerations or even perfora- 
tions of the uterus. 

6. Hernia of the uterus (one or both horns). — 
This is a most untoward complication of parturi- 
tion. It occurs usually before labor commences. 
Attempts at reduction and ordinary delivery may be 
made, but cesarean section is usually the only solu- 
tion of the difficulty. 

7. Torsion of the uterus. — Twist of the uterus 
occurs but rarely and may be diagnosed by the 
futility of the uterine contractions and the imper- 
viousness of the cervix. Sometimes the twist may 
be felt by digital examination. Failing to reduce 
the torsion by manipulation — that is, by fixing the 
OS by the pressure of a finger or fixation forceps 
and rolling the bitch over in a direction opposite to 
that of the twist, cesarean section must be per- 
formed promptly. 

It may seem that cesarean section is unduly em- 
phasized and advocated in these pages, but the 
author's experience has been that, when performed 
early and skillfully executed, it holds out by far 
the best chance for life both to the mother and her 
young, and that blind endeavor with the forceps, 
with no room for a guiding finger, are far more fatal 
and' much less justifiable. In fact, cesarean section, 
properly performed and at the right time, is a re- 
markably safe operation and should not occasion 
a higher mortality than simple ovariotomy. 

Fetal Dystocia 

No very definite rules can be laid down regarding 
fetal dystocia, since every case is a law unto itself. 

1. Malformations. — In the case of deformed or 
malformed puppies it may be necessary to perform 
embryotomy before delivery can take place, or the 



232 



CANINE MEDICINE AND SURGERY 



fetus may be crushed with the forceps, in this way 
making possible its passage through the natural out- 
let. Extra large puppies, if the presentation is nor- 
mal — that is,' head, nose, and fore legs in line — often 
necessitate the use of traction either by means of 
the forceps or a snare. Great care in the selection 
of the forceps is necessary. Those with overlapping 
handles should be discarded on account of the danger 
of pinching and lacerating the vaginal mucous mem- 
brane. They should be adjusted well around the 
head, given a turn to make sure that only the "fetus 
is grasped, and traction applied only during expul- 
sive efforts of the mother. 

2. Malpresentation. — The variations of malpresen- 
tations are legion and of such variety that a minute 




Bad Type of Parturition Forceps — Note the Overlapping Blades. 

description of them would be liable to confuse the 
student and serve no good purpose. The main facts 
to remember are that the fetus can be delivered 




A Better Forcep, but Jaws Patterned After No. 1 Are Preferable. 

without embryotomy or cesarean section only if 
head, nose, and fore legs are in line, or if the hind 
legs and hind quarters are presenting. Therefore 




Wire Ecraseur — A. Very Useful and Safe Instrument for Use in 
Embryotomy. 



OBSTETRICS 233 

every effort must be made to manipulate the fetus 
into one or the other of these two positions. Great 
patience and skillful manipulation with the finger 
are required and must be persisted in until either 
the dfcsired result is attained or found to be impos- 
sible, when a decision between embryotomy and 
cesarean section must be made. 

3. Abnormal size. 

4. Hydrocephalus. — The abnormal size of the head 
must be reduced by puncture and draining with a 
trocar and cannula, followed by crushing with the 
forceps, when delivery can usually be effected easily. 

5. Gaseous distension. — Gaseous distension of the 
abdomen of the fetus should be reduced by puncture 
with the trocar and cannula. 

6. Double engagement. — Two puppies presenting 
at the same time is a common occurrence, and is 
a source of great trouble to the practitioner, it being 
difficult to diagnose and still harder to rectify. Hav- 
ing recognized the condition by digital examination, 
the head of one puppy must be grasped with the 
forceps and traction exerted, the other puppy in the 
meanwhile being pushed back as far as possible with 
a repeller. 

Accidents Liable to Occur During Parturition 

Exhaustion 

In difficult and prolonged deliveries one or more 
of the puppies may die, or the bitch may gradually 
sink from exhaustion. 

Lacerations of the Vagina 

This accident usually occurs either from the in- 
cautious use of forceps or from the use of unsuit- 
able forceps. The author has seen cases where com- 
plete rupture of the vagina had occurred and pro- 
lapse of the intestines taken place. These lacera- 



234 CANINE MEDICINE AND SURGERY 

tions are always a grave source of danger from 
subsequent septic toxemia and must receive careful 
and thorough antiseptic treatment. Prolapse of the 
bladder, vide, may occur after rupture of the vagina. 

Rupture of the Uterus 

This serious accident is usually the result of too 
strenuous efforts to extract a dead fetus, the walls 
of the uterus having become weakened and friable 
from the solvent action of the products of decom- 




Snare for Extracting Puppies, Made Out of Flexible Copper Wire 
(A) and a Nickel-plated Thermometer Case (B). A Safe and 
Efficient Substitute for the Ordinary Forceps. Especially Useful 
in Small Bitches. 

position of the dead puppy. The symptoms are 
vomiting, collapse, and a running down, weak pulse. 
The only chance for recovery lies in immediate 
laparotomy, suture of the rent in the uterus after 
it is properly cleaned, removing fetus and placenta, 
or total extirpation of the organ after double liga- 
tion. Otherwise septic peritonitis will prove rapidly 
fatal. Before closing the abdomen, the abdominal 
cavity must be irrigated with a decinormal saline 
solution. The prognosis is very unfavorable. 

Sequelae to Parturition 
Vaginitis 

Inflammation of the vagina is almost invariably 
the result of difficult labor, and is especially com- 
mon in cases that have required prolonged manipu- 
lation and forceps delivery. It is indicated by a whit- 
ish, purulent discharge, sometimes with an ex- 
tremely offensive odor. Upon examination of the 
vagina by means of a speculum the mucous mem- 
brane is found to be hyperemic, swollen, and cov- 



OBSTETRICS 235 

ered with a grayish-colored mucous exudate. Con- 
siderable tenderness may also be present and the 
examination resented by the patient, especially if 
the mucous membrane is extensively lacerated. 

Treatment. — This consists of irrigations of anti- 
septics and astringents, such as solutions of chinosol 
1-1000, one-per-cent potassium permanganate, one- 
per-cent sulphate of zinc, one-per-cent creolin, or 
the iodin saline solution mentioned elsewhere (nor- 
mal saline solution, one pint ; tincture of iodin, one 
dram). 

Prolapse of the Vagina and Uterus 

Of the two, prolapse of the vagina is most com- 
mon. In neglected cases grave alterations, chiefly 
of a hypertrophic character, may take place in the 
vaginal mucous membrane, even gangrene some- 
times resulting. 

Symptoms. — The vagina protrudes through the top 
of the vulva and appears as a pear-shaped mass of 
inflamed tissue. In recent cases it appears moi-^t 
and covered with mucous ; later it becomes drier 
and of a dark red or brown color. 

In prolapse of the uterus, one horn only comes 
down and protrudes from the vulva as a mass of 
inflamed, mucous-covered tissue having salient 
borders. 

Treatment. — Clean thoroughly with antiseptic so- 
lutions, and if much congestion is present constrict 
the blood vessels with local application of adrenalin 
solution, pushing back the prolapsed organ and tak- 
ing care to restore the parts to their normal posi- 
tion. Otherwise straining will invariably take place. 
To overcome this, a dose of one-fourth to one grain 
of morphin sulphate or one to three tablets (No. 1) 
of H-M-C should be given, and repeated as neces- 
sary. 



236 CANINE MEDICINE AND SURGERY 

After the vagina has been replaced and smoothed 
out the lips of the vulva should be drawn together 
with two or three stitches, leaving only a sufihcient 
opening for urination. The sutures may be left in 
three days or longer, as required to prevent further 
prolapse. 

In prolapse of the uterus it is often almost an 
impossibility to completely smooth out the horn to 
its normal shape, even by means of some blunt, 
smooth instrument, and in such cases a recurrence 
of the prolapse may be looked for. Unless the 
uterus is completely replaced, straining will in- 
variably persist and the condition recur. In these 
cases either one of two courses of surgical inter- 
ference may be followed out: (1) laparotomy, re- 
duction of the prolapse, and suture of prolapsing 
horn to the abdominal parietes, or (2) laparotomy 
and amputation of the offending horn, or total ex- 
tirpation of the uterus. 

The first procedure gives good results and should 
be practiced in cases where the uterus has suffered 
little or no injury from exposure or trauma. The 
second is indicated where grave changes have taken 
place in the uterus, and this is far preferable to the 
old operation of ligating and amputation, or amputa- 
tion with the ecraseur. • 

Metritis 

Inflammation of the uterus is a common sequel 
to difificult, prolonged, or badly-handled labor, and 
is manifested in two forms: (1) simple metritis, 
which is a catarrhal inflammation of the mucous 
membrane, and (2) septic metritis, or puerperal 
fever, which is a very serious condition. 

SIMPLE METRITIS 

Symptoms. — The vulva is swollen and congested 
and there is a copious discharge of purulent, sanious, 



OBSTETRICS 237 

or sometimes putrid matter, increased in quantity- 
after urination or defecation. 

Tlie animal draws attention to the hinder parts 
by constant licking, and the discharge may escape 
noticx unless a careful examination is made. Slight 
constitutional disturbances occur ; the appetite is 
capricious, and sometimes there is slight elevation 
of temperature. Unless treatment is prompt the 
condition is liable to become chronic. 

Treatment. — Constitutional disturbances should be 
treated as they arise and the uterus and vagina 
flushed out daily with antiseptic, astringent solu- 
tions. Chinosol (1-1000) and one-per-cent potassium 
permanganate are among the best. The chronic 
form demands both local and constitutional treat- 
ment — one-per-cent solution of sulphate of zinc ad- 
ministered locally and iron tonics internally — to tone 
up the system. In very obstinate cases nuclein and 
the use of the staphylobacterins give good results 
and should be given a trial. 

SEPTIC METRITIS— PUERPERAL FEVER 

This is in reality a case of wound infection, and 
besides the intense inflammation of the uterus itself 
it is always accompanied by grave constitutional 
disturbances. 

The parturient uterus is exceedingly susceptible 
to bacterial invasion and absorbs toxins readily, so 
that blood clots and remnants of a placenta which 
so freely decompose, are among the chief causes of 
this condition. As stated before, wounds and lacera- 
tions are of exceedingly grave import at this time, 
and readily become portals for the entrance of 
bacteria and their products into the circulation. 

The intense inflammation of the mucous mem- 
brane extends to the deeper structures of the uterine 
walls, and often to the broad ligament and peri- 



238 CANINE MEDICINE AND SURGERY 

toneum, when the case becomes complicated with a 
septic peritonitis. The constitutional symptoms are 
suppression of the mammary secretion, vomition, 
anorexia, great prostration, and weak, rapid pulse 
of a thready nature and gradually becoming imper- 
ceptible. The respirations are increased in fre- 
quency. The temperature at first is very high, but 
later on falls rapidly to subnormal in cases approach- 
ing a fatal termination. Local symptoms are pain 
on pressure to the abdomen, and copious, foul- 
smelling discharge from the vulva ; the mucous mem- 
brane of the vulva and vagina is swollen, con- 
gested, and of a deep reddish-purple color. Mucous 
membrane of the mouth and lips is at first hyper- 




Uterine Douche Tube. 

emic, but later of a livid color, and cold and clammy 
to the touch. 

Acute cases run from twelve to twenty-four hours, 
and the prognosis is as a rule unfavorable. 

Treatment. — To be successful, treatment must be 
instituted early and must be pushed energetically. 
Nuclein should be given from the outset, and ad- 
ministered three times daily until recovery, and the 
following given every three hours to efifect: ergotin, 
quinin sulphate, iron phosphate, and fluid extract 
of echinacea, of each two grains. 

To combat the great prostration, stimulants should 
be given, such as one dram of spirits of camphor, 
hypodermically every three hours. 

The vagina and uterus must be irrigated out sev- 
eral times a day, first with a sterile, warm, normal 



OBSTETRICS 239 

saline solution, until the solution runs out clear; 
then with antiseptic solutions of chinosol or po- 
tassium permanganate. After thoroughly irrigating 
as above described, the uterus should be filled with 
a hot, normal, saline solution and the patient allowed 
to retain it as long as possible. 

Antistreptococci serum should be injected hypo- 
dermically, giving ten centimeters once or twice a 
day. Hot applications, such as antiphlogistin poul- 
tices, applied to the abdomen give relief from the 
abdominal pain. The patient should be kept warmly 
covered, and the diet restricted to beef tea, milk, or 
meat extracts. 

The after-treatment consists of a generous diet 
and tonics, gentle exercise, and the avoidance of 
exposure to wet and cold. 

Mammitis 

Inflammation of the mammse and lacteal glands is 
of common occurrence in neglected bitches and in 
heavy milkers. It may vary from a slight conges- 
tion to intense inflammation with abscess formation, 
sloughing, and obliteration of portions of the glands. 

Cause. — The causes are invasion of pyogenic 
bacteria, retention of milk (the result of taking the 
puppies away immediately after birth, or too early, 
or from their death), or from cold and wet, and 
lying on a cement floor or damp earth. 

Symptoms. — Indications of mammitis are shown 
by tenseness and tenderness of the parts ; the milk 
is curdled, sometimes blood-stained, and, if abscess 
formation has taken place, accompanied by pus. The 
constitutional symptoms, varying with the intensity 
of the inflammatory processes, are raised tempera- 
ture, partial or complete anorexia, rigors, and con- 
stipation. It is highly important that these cases be 
taken in hand at once. 



240 CANINE MEDICINE AND SURSERY 

Treatment. — First of all a purgative should be 
given, one to three grains of calomel or one or two 
compound cathartic pills, U. S. P. or B. P., and if 
necessary the pain may be controlled by one fourth 
grain of morphin sulphate or one tablet of H-M-C 
(No. 1). Give calcium sulphide in one-sixth-grain 
doses every half hour until the breath smells 
strongly of hydrogen sulphid. 

The affected parts must be fomented with hot 
water and the mammse gently massaged and milked 
out, care being taken to entirely remove all the 
clotted or curded milk. The fomentations may be re- 
peated or a hot antiphlogistin poultice applied, the 
massaging being repeated after removal of the 
poultice. 

After the acute stage is passed, inunctions of 
warm camphorated oil are of service. Abscess for- 
mation must be treated by free incision and anti- 
septic treatment. 

Neglected cases may lead to induration of por- 
tions of the mammary glands, leaving the so-called 
mammary tumors. 

Eclampsia 

Eclampsia is a tonic-clonic convulsive spasm 
which attacks suckling bitches generally about the 
second or third week after parturition, sometimes 
earlier. It usually attacks bitches that are heavy 
milkers and that have heavy litters of puppies. The 
bitch is generally an extra good mother, the puppies 
as a rule laying on flesh rapidly. 

The cause of this trouble is still somewhat in 
dispute, but the prompt response to the eliminative 
treatment rather seems to indicate that the retention 
of autotoxins is the cause. 

Symptoms. — An attack comes on suddenly, the 
symptoms at first not being very well marked. The 



OBSTETRICS 241 

patient becomes restless and anxious ; the eyes stare 
and respirations are increased ; the mucous mem- 
branes are injected ; muscular twitchings make their 
appearance, and the patient falls down and is un- 
able to rise. The patient then lies on her side with 
stiffened legs, the muscles becoming hard and tense, 
quivering at intervals. Clonic convulsions of all the 
muscles occur, especially those of the extremities ; 
the respiratory muscles are also largely involved, 
in consequence of which the respirations become 
quickened and labored ; the mouth opens, and the 
tongue protrudes and appears greatly enlarged. All 
visible mucous membranes are cyanosed ; the pulse 
is small, hard, and rapid, and the temperature is 
normal or subnormal. The eyes are staring and 
the expression anxious, but consciousness persists 
throughout. 

The mammae become flaccid and the secretion of 
milk is suppressed. Rigidity of the extremities is 
one of the most prominent phenomena, the joints 
being flexed only with great difficulty. In untreated 
cases, coma supervenes before death. 

Treatment. — Narcotic and antispasmodic agents 
are indicated and should be combined with elimina- 
tive treatment. The line of treatment giving the 
best result in the author's hands is as follows : 

Give hypodermically three H-M-G tablets (No. 1) 
to a bitch the size of a fox terrier and five tablets 
(No. 1) to one of the size of a collie. Induce anes- 
thesia with chloroform by the drop method, keeping 
it up until the H-M-G has taken effect. The patient 
being completely relaxed, give hypodermically one 
twentieth grain of veratrin hydrochlorid. 

Repeat the H-M-G as often as necessary to control 
the spasms, always pushing it to effect regardless 
of dosage. A brisk purge should be given as soon as 
the patient is able to swallow, one to three grains 



242 CANINE MEDICINE AND SURGERY 

of calomel or the compound cathartic pill, U. S. P. or 
B. P. After the attack, the puppies should be 
weaned immediately and the bitch's strength built 
up by a generous diet and a course of tonics. 



INDEX 



Abdomen, operations on the, 
205 

surgery of the, 203 
Abdominal dropsy, 77 
Abscess of tlae cornea, 124 

of the testicle, 103 
Accidents during parturition, 

233 
Acne, 147 
Acute Bronchitis, 17 

endocarditis, 106 

gastritis, 51 

inflammation of the kid- 
ney, 82 

nephritis, 82 
Administration of medicines, 

the, 9 
Alopecia, 146 
Amputation of claws, 223 

of the prolapsed rectum, 
69 

of the tail, 221 . 
Anal glands, obstruction of 

the, 72 
Anastomosis, intestinal, 209 
Anemia of the brain, 115 
Anesthesia, 181 

general, 182 
Aneurysms, 111 
Ankylostomum trigonocepha- 

lum, 168 
Anthrax, 160 
Anus, Absence of, 72 

diseases of the, 66 

fistula of, 71 

prolapsus of, 70 
Apoplexy, 118 
Arsenic poisoning, 173 
Ascaris marginata, 166 
Ascites, 77 
Atresia ani, 72 

Auditory canal, catarrh of 
the, 132 



B 

Bandage, description of Pri- 

essnitz, 48 
Bismuth-paraffin paste, for- 
mula of, 72 
Bladder, diseases of the, 90 

eversion of the, 97 

inflammation of the, 90 

prolapse of the, 96 

retroflexion of the, 95 

stone in the, 94 

tumors of the, 95 
Blood, diseases of the, 111 

parasites of the, 111 
Blood Vessels, diseases of the, 
105-111 

parasites of the, 112 
Brain, anemia of the, 115 

emulsion for treatment 
of chorea, 153 

inflammation of, 113 
Bronchi and lungs, diseases 

of the, 17 
Bronchitie, 17 

acute, 17 

chronic, 20 



Calculi of the bladder, 94 
urethral, 98 

Canker of the ear, 132 

Carbolic acid (phenol) poi- 
soning, 178 

Cardiac hypertrophy, 109 

Caries dentum, 45 
of the teeth, 45 

Cataract, 128 

Catarrh of the auditory canal, 
132 

intestinal, 55 

Catarrhal jaundice, 74 

pneumonia, lobular, 25 

Catarrh, simple nasal, 1^ 

Cerebral hemorrhage, 115 

Cerebrospinal meningitis, 117 



243 



244 



INDEX. 



Cesarean section, 212 
Choking, 48 
Cliorea, 151 

brain emulsion for treat- 
ment of, 153 
Clironic bronchitis, 20 

endocarditis, 107 

gastritis, 52 

laryngitis, 15 

nephritis, 84 
Cirrhosis of the liver, 76 
Claws, amputation of, 223 
Cleft palate, harelip and, 43 

operation for, 191 
Cold in the head, 12 
Colic, 56 
Congenital opacities of the 

cornea, 127 
Conjunctiva, information of 

the, 122 
Conjunctivitis, 122 
Constipation, 60 
Constitutional diseases, infec- 
tious, 148 
Cornea, abscess of the, 124 

congenital opacities of 
the, 127 

opacities of the, 126 
Coryza, 12 

Croupous pneumonia, 21 
Crystalline lens, opacity of 

the, 128 
Curette, French's rectal, 61 
Cystitis, 90 

prescriptions for, treat- 
ment of, 92 
Cysts, interdigital, 224 
Czerny-Lembert suture, 208 



Deafness, 133 
Degenerations of the kidney, 

87 
Demodectic mange, 136 
Dental formula, 43 
Dermatitis, parasitic, 140 
Diabetes insipidus, 88 
mellitus, 80 

mellitus, prescription for 
treatment of, 81 
Diarrhea, 58 

prescriptions for treat- 
ment of, 59 
Dilation of the heart, 109 



Diseases, infectious constitu- 
tional, 148 

of the bladder, 90 

of the blood and blood 

vessels, 111 
of the bronchi and lungs, 

17 
of the ear, 131 
of the eye, 122 
of the heart and blood 

vessels, 105 
of the kidney, 82 
of the liver, 74 
of the mouth, pharynx 

and esophagus, 37 
of the nervous system, 

113 
of the pleurae, 31 
of the prostate, urethra 

and prepuce, 98 
of the rectum and anus, 

66 
of the retina, 129 
of the skin, 135 
of the stomach and in- 
testines, 50 
of the testicles and scro- 
tum, 103 
of the upper respiratory 

passages, 12 
venereal, 162 
Dislocations, 219 
Displaced orbital gland, 199 
Distemper, 148 

prescription for, 153 
Dobell's solution, formula of, 

47 
Donovan's solution, formula 

of, 153 
Dover's powder, formula of, 

56 
Dropsy, abdominal, 77 

prescription for the treat- 
ment of, 79 
of the thoracic cavity, 34 
Dumb rabies, 158 
Dystocia, 228 

due to abnormal size, 233 
due to constrictions of 

the vagina, 229 
due to double engage- 
ment, 233 
due to gaseous distension, 
233 



INDEX. 



245 



Dystocia — 

due to hernia, 231 
due to liydrocephalus, 233 
due to malformations, 231 
due to malpresentation, 

232 
due to tumors of the os, 
cervix and vagina, 229 
due to pelvic malforma- 
tion, 228 
due to rigid pelvis, 229 
due to torsion of the 

uterus, 231 
due to uterine inertia, 

230 
fetai, 231 
maternal, 228 



Ear, canker of the, 132 
diseases of the, 131 
Earflap, hematoma of the, 188 

ulceration of the, 131 
Ears, operation for split, 189 
Eclampsia, 240 
Ectropion, 198 
Eczema, 142 

Emollient, formula of, 138 
Empyema, superior maxillary 

sinus, 46 
Encephalitis, 113 
Endocarditis, acute, 106 

chronic, 107 
Enterectomy, 209 
Enteritis, 63 
Enterotomy, 209 
Entropion, 196 
Enucleation of the eyeball, 

200 
Epilepsy, 119 
Epistaxis, 13 
Epulis, 41 
Erythema, 141 
Esophagotomy, 192 
Esophagus, diseases of the, 37 
foreign bodies in the, 48 
Eversion of the bladder, 97 
Examination of patient, 7 
Exhaustion due to parturition, 

233 
Extremities, necrosis of the, 
220 

tumofs of the, 220 
Eye, diseases of the, 122 



Eyeball, enucleation of the, 
200 

foreign bodies in, 195 
surgery of the, 194 
surgical injuries of the, 
194 
Eyelids, warts on the, 195 

F 
Favus, 138 
Femoral hernia, 218 
Fetal dystocia, 231 
Filari immitis. 111 
Fistula in ano, 71 
Follicular mange, 136 
Forceps, obstetric, 232 
Foreign bodies in the esopha- 
gus, 48 

in the eye, 195 
in the stomach, 53 
Formula, dental, 43 

for the treatment of sto- 
matitis, 38 
of bismuth-paraffin paste, 

72 
of Dobell's solution, 47 
of Donovan's solution, 

153 
of Dover's powder, 56 
of emollient, 138 
of Lassar's Paste, 138 
of Lugol's solution, 40 
Fractures, 222 
Furious rabies, 156 

G 

Gastritis, 51 

acute, 51 

chronic, 52 

prescriptions for the 
treatment of, 53 
Gastrotomy, 207 
General anesthesia, 182 

remarks, 7 
Glans, tumors of the, 102 
Glaucoma, 129 
Glossitis, 40 
Granuloma, 162 

H 

Hands, preparation of the 

operators, 186 
Harelip and cleft palate, 43 

operation for, 190 
Head, cold in the, 12 

surgery of the, 188 



246 



INDEX. 



Heart, diseases of the, 105 

hypertrophy and dila- 
tion of the, 109 

rupture of the, 110 

valvular defects of the, 
107 
Hematogenous icterus, 75 
Hematoma of the earflap, 

188 
Hamatozoa, 111 
Hemiplegia, 116 
Hemorrhage, cerebral, 115 
Hemorrhoids, 66 
Hepatitis, 76 

interstitial, 76 
Heptogenous Icterus, 75 
Hernia, femoral, 218 

inguinal, 216 

operations for, 215 

perineal, 217 

scrotal, 217 

umbilical, 215 

ventral, 216 
Hook Worms, 168 
Hydrocyanic acid poisoning, 

177 
Hydrothroax, 34 
Hypertrophy and dilatation 
of the heart, 109 

cardiac, 109 

of the prostate, 100 
Hypodermic administration 

of medicines, 10 
Hysterotomy, 212 

I 

Icterus, 74 

hematogenous, 75 
heptogenous, 75 
Impaction of the stomach, 

50 
Infectious constitutional dis- 
eases, 148 
Inflammation of the bladder, 
90 

of the brain, ll3 

of the conjunctiva, 122 

of the kidney, acute, 82 

of the liver, 76 

of the parotid gland — 

mumps, 47 
of the pelvis of the kid- 
ney, 87 
of the pleura, 31 
of the spinal cord, 117 



of the testicles, 103 

of the throat, 46 

of the urethra, 98 

of the uterus, 236 

of the vagina, 234 
Inguinal hernia, 216 
Injuries of the eye, surgical, 

194 
Instruments, preparation of, 

185 
Interdigital cysts, 224 
Internal parasites and para- 
sitisms, 165 
Interstitial hepatitis, 76 
Intestinal anastomosis, 209 

catarrh, 55 
Intestines, diseases of the, 50 

surgery of the, 209 

tumors of the, 65 
Intravenous administration 

of medicines, 10 
Intussusception, 57 
Iodoform poisoning, 179 
Iritis, 127 

J 
Jaundice, 74 ' 

catarrhal, 74 

malignant malarial, 7b 

K 

Kkuatitis, 123 

interstitialis, 124 
superficialis, 123 
suppurative, 124 
Kidney, acute inflammation 
of the, 82 

diseases of the, 82 
inflammation of the pel- 
vis of the, 87 



Lackrations of the vagina, 
233 

Laparotomy, 205 

Laryngitis, 14 
chronic, 15 

Lassar's paste, formula ofi, 
138 

Legs, surgery of the, 219 

i^ithiasis, 94 

Lithotomy, suprapubic, 213 

Liver, cirrhosis of the, 76 
diseases of the, 74 
inflammation of the, 76 



INDEX. 



247 



Lobar (croupous) pneumo- 
nia, 21 

Lobular (catarrhal) pneumo- 
nia, 25 

Lugol's solution, formula of, 
40 

Lungs, diseases of the bron- 
chi and, 17 

M 
Malarial Jaundice, malig- 
nant, 75 
Mammitis, 239 
Mange, demodectic, 136 
follicular, 136 
prescription for, 136 
sarcoptic, 135 
Marginata, ascaris, 166 
Mastitis, 239 
Maternal dystocia, 228 
Maxillary sinus, empyema of 

the superior, 46 
Medicines, the administra- 
tion of, 9 
Meningitis, cerebrospinal, 

117 

spinalis, 117 
Metritis, 236 

septic, 237 
Monoplegia, 116 
Mouth, diseases of the, 37 
Mumps, 47 
Myelitis, 117 

N 
Nasal Catarrh, simple, 12 
Neck, surgery of the, 188 
Necrosis of the extremities, 

220 
Necrotic stomatitis, 38 
Nephritis, acute, 82 
chronic, 84 
suppurative, 86 
Nervous system, diseases of 
the, 113 

O 
Obstetric Forceps, 232 
Obstetrics, 225 
Obstruction of the anal 

glands, 72 
Opacities of the cornea, 126 
of the cornea, congenital, 
127 
Opacity of the crystalline 
lens, 128 



Operation for cleft palate, 
191 

for harelip, 190 
for split ears, plastic, 
189 
Operations on the abdomen, 
205 

for hernia, 215 
Operative area, preparatory 

treatment of the, 185 
Operator's hands, prepara- 
tion of the, 186 
Ophthalmia, periodical, 129 
Oral administration of medi- 
cines, 9 
Orbital gland, displaced, 199 
Orchitis, 103 
Ovariohysterectomy, 211 
Ovariotomy, 211 
Oxyuris vermicularis, 167 

P 
Palate, cleft, 43 

operation for cleft, 191 
Papilloma, 42 

Paracentesis abdominis, 204 
thoracis, 203 
versicae, 204 
Paralysis of the sphincter 

vesicae, 93 
Paraphimosis, 101 
Parasites and parasitisms, 
internal, 165 
intestinal, 166 
of the blood and blood 

vessels, 111 
of the kidney, 88 
Parasitic dermatitis, 140 
Parotid gland, inflammation 

of the, 47 
Parotitis, 47 

Parturition, accidents dur- 
ing, 233 
sequelae to. 234 
Pericarditis, 105 
Perineal hernia, 217 
Periodical ophthalmia, 129 
Pharyngitis, 46 
Pharynx, diseases of the, 37 
Phimosis, 101 
Phosphorus poisoning, 174 
Piles, 66 
Pin Worms, 167 
Plastic operation for split 
ears, 189 



248 



INDEX. 



Pleura, inflammation of the, 

31 
Pleurae, diseases of the, 31 
Pleurisy, 31 \ 

Pleuritis, 31 
Pleurodynia, 35 
Pneumonia, 21 

lobar (croupous), 21 
lobular (catarrhal), 25 
prescription for treat- 
ment of, 30 
Poisoning, arsenical, 173 

carbolic acid (phenol), 

178 
hydrocyanic acid, 177 
iodoform, 179 
pathology of, 171 
phosphorus, 174 
potassium cyanid, 177 
strychnin, 175 
Poisons and poisoning, 171 
Preliminaries, surgical, 180 
Preparation of instruments, 
185 

of the operator's hands, 
186 
Preparatory treatment of 

the operative area, 185 
Prepuce, diseases of the, 98 

tumors of the, 102 
Prescription for distemper, 
153 
for mange, 136 
for ringworm, 139 
for the ■ treatment of 

dropsy, 79 
for treatment of pneu- 
monia, 30 
for vermifuge, 167 
Prescriptions for treatment 
of cystitis, 92 

for treatment of diar- 
rhea, 59 
for the treatment of gas- 
tritis, 53 
Priessnitz bandage, descrip- 
tion of, 48 
Prolapse of the bladder, 96 
Prolapsed rectum, amputa- 
tion of the, 69 
Prolapse of the vagina and 

uterus, 235 
Prolapsus ani, 70 
recti, 67 



Prostate, diseases of the, 98 
hypertrophy of the, 100 
tumors of the, 101 
Prostatitis, 99 
Pterygium, 198 
Puerperal fever, 237 
Puppy snare, 234 
Pyelitis, 87 

Q 
Quinine treatment for ra- 
bies, 158 

R 
Rabies, 155 
dumb, 158 
furious, 156 

quinine treatment for, 
158 

serum treatment for, 158 
Ranula, 41 
Rectal administration of 

medicines, 11 
Rectum, amputation of the 
prolapsed, 69 

diseases of the, 66 
prolapsus of, 67 
Respiratory passages, dis- 
eases of the upper, 12 
Retina, diseases of the, 129 
Retroflexion of the bladder, 

95 
Rhinitis, 12 
Ringworm, 138 

prescription for, 139 
Round Worms, 166 
Rupture of the heart, 110 
of the uterus, 234 
S 
Sahcoptic Mange, 135 
Scrotal hernia, 217 
Scrotum, diseases of the, 103 

tumors of the, 104 
Septic metritis, 237 
Sequelae to parturition, 234 
Serum treatment for rabies, 

158 
Sheele's acid, 184 
Sinus, empyema of the supe- 
rior maxillary, 46 
Skin, diseases of the, 135 
Snare, puppy, 234 
Sore throat, 46 
Spasm of the sphincter vesi- 
cae, 92 
Spaying, 211 



INDEX. 



249 



Sphincter vesicae, paralysis 
of the, 93 

spasm of the, 92 
Spinal cord, inflammation of 

the, 117 
Spiroptera sanguinolenta, 

112-166 
Split ears, plastic operation 

for, 189 
Sprains, 219 

Stomach, diseases of the, 50 
foreign bodies in the, 53 
impaction of the, 50 
Stomatitis, 37 

formula for the treat- 
ment of, 38 
necrotic, 38 
ulcerosa, 38 
Stone in the bladder, 94 
Strongylus vasorum, 112 
Strychnin poisoning, 175 
Supperative keratitis, 124 

nephritis, 86 
Suprapubic lithotomy, 213 
Surgery of the eye, 194 

of the head and necli, 188 
of the intestines,^ 209 
of the legs and tail, 219 
of the thorax and abdo- 
men, 203 
Surgical preliminaries, 180 
Suture, Czerny-Lembert, 208 

T 

T.EMA. 169 

Tail, amputation of the, 221 
surgery of the, 219 

Tapeworms, 169 

Tartar, 44 

Teeth, the, 43 

caries of the, 45 

Testicle, abscess of the, 103 

Testicles, diseases of the, 103 
inflammation of the, 103 
tumors of the, 104 

Tetanus, 158 

Thoracic cavity, dropsy of 
the, 34 

Thorax, surgery of the, 203 

Thread worms, 166 



Throat, inflammation of tlie, 

46 
Tracheotomy, 192 
Treatment of the operative 

area, preparatory, 185 
Tricocephalus depressiuscu- 

lus, 169 
Tuberculosis, 161 
Tumors of the bladder, 95 
of the extremities, 220 
of the glans, prepuce, and 

vagina, 102 
of the intestines, 65 
of the liidney, 87 
of the mouth, 42 
of the prostate, 101 
of the testicles and scro- 
tum, 104 
Typhlitis, 62 

U 
Ulceration of the earflap, 

131 
Umbilical hernia, 215 
Urethra, diseases of the, 98 
Urethral calculi, 98 
Urethritis, 98 
Urticaria, 146 
Uterine douche tube, 238 
Uterus, inflammation of the, 
236 

prolapse of the, 235 
rupture of the, 234 



Vagina, inflammation of the, 
234 
lacerations of the, 233 
prolapse of the, 235 
tumors of the, 102 
Vaginitis, 234 
Valvular defects of the heart, 

107 
Venereal disease, 162 
Ventral hernia, 216 
Vermifuge, prescription for, 
167 

W 
Warts in the mouth, 42 
on the eyelids, 195 



i 
t 



